Management of diabetes during open heart surgery.

The management of 5 insulin-dependent diabetics following open heart surgery was studied and compared with a group of 5 similar diabetics who had undergone urological or orthopaedic operations. The patients were all treated with a glucose/insulin/potassium infusions regimen, but the cardiac group needed much greater amounts of insulin (1.0 unit/g of glucose) than the non-cardiac group (0.3 units/g) to achieve a similar level of control. The high requirements of the cardiac patients are probably related to trauma, hypothermia and glucose loading when cardiopulmonary bypass begins. Diabetics undergoing such surgery need suitably modified insulin regimens from the outset.