Pezzarossa A, Taddei F, Cimicchi M C, Rossini E, Contini S, Bonora E, Gnudi A, Uggeri E
Istituto di Clinica Medica Generale, Università degli Studi di Parma, Italy.
Diabetes Care. 1988 Jan;11(1):52-8. doi: 10.2337/diacare.11.1.52.
The purpose of this study was to validate methods for the perioperative management of diabetic patients that meet the prerequisites of simplicity, applicability in the absence of a diabetologist, and flexibility, to rapidly meet changing metabolic requirements. The patients were divided into two groups that were comparable for age, sex distribution, type of diabetes, and type of surgical procedures. The results show that intravenous insulin administration achieved better glycemic control during the intraoperative period, whereas it did not offer advantages over the subcutaneous route during the pre- and postoperative periods. The satisfactory degree of steady glycemic control achieved and the absence of hypoglycemic episodes indicate that the separate administration of insulin and glucose plus electrolytes is an effective and safe management modality for diabetic patients undergoing major surgery.
本研究的目的是验证符合简单性、在没有糖尿病专科医生的情况下可应用以及灵活性等前提条件的糖尿病患者围手术期管理方法，以便迅速满足不断变化的代谢需求。患者被分为两组，这两组在年龄、性别分布、糖尿病类型和手术类型方面具有可比性。结果表明，术中静脉注射胰岛素能实现更好的血糖控制，而在术前和术后阶段，与皮下注射途径相比并无优势。所实现的血糖稳定控制的满意程度以及无低血糖发作表明，单独给予胰岛素以及葡萄糖加电解质是接受大手术的糖尿病患者的一种有效且安全的管理方式。
