Abstract
BackgroundPoor perioperative glycemic control increases risk of infection, cardiovascular accidents and mortality in patients undergoing surgery. Tight glycemic control by insulin therapy is known to yield better outcomes in such patients. Intravenous (IV) insulin therapy with or without adjunctive subcutaneous insulin therapy is the mainstay of managing hyperglycemia in perioperative period. This observational study assessed the safety of IV Insulin Aspart (IAsp) as compared to Regular Human Insulin (RHI) in patients undergone cardiac surgery at a tertiary care hospital.Methods203 patients received IV IAsp (n = 103) and RHI (n = 100) respectively. Safety was assessed by frequency and severity of adverse events (AEs) & serious adverse events (SAEs) during hospitalization.ResultsIAsp effectively controlled mean blood glucose levels to 159.87 ± 41.41 mg/dl similar to RHI (160.77 ± 44.39 mg/dl). No serious adverse event was reported. The incidence of hypoglycemia was similar in both the groups. The insulin infusion rate, time for which insulin infusion was withheld and mean blood glucose during hypoglycemia was significantly high in RHI group.ConclusionThis study has shown similar safety of IV IAsp as compared to IV RHI in the post cardiac surgery patients. However physicians preferred IAsp as it offers advantage during transition. IV IAsp offers an effective and safe option for managing hyperglycemia in patients in ICU post cardiac procedures.
Highlights
Hyperglycemia secondary to diabetes, impaired glucose tolerance or stress-induced hyperglycemia is a common complication in hospitalized patients [1]
No serious adverse event was noted during the study
Severity of adverse events was more in Regular Human Insulin (RHI) group as compared to Insulin Aspart (IAsp) group, 15 moderate level adverse events were noted in RHI group as compared to 11 in IAsp group (Table 3)
Summary
Hyperglycemia secondary to diabetes, impaired glucose tolerance or stress-induced hyperglycemia is a common complication in hospitalized patients [1]. It is estimated to reach around 101.2 million by the year 2030 [5] With this increase in prevalence, India faces an epidemic of Type 2 diabetes. Intravenous (IV) insulin therapy with subcutaneous (SC) insulin is the mainstay of treatment in management of Hyperglycemia in hospitalized patients and has shown to improve morbidity and reduce. Poor perioperative glycemic control increases risk of infection, cardiovascular accidents and mortality in patients undergoing surgery. Intravenous (IV) insulin therapy with or without adjunctive subcutaneous insulin therapy is the mainstay of managing hyperglycemia in perioperative period This observational study assessed the safety of IV Insulin Aspart (IAsp) as compared to Regular Human Insulin (RHI) in patients undergone cardiac surgery at a tertiary care hospital
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