A standardized glucose-insulin-potassium infusion protocol in surgical patients: Use of real clinical data from a clinical data warehouse

Diabetes Res Clin Pract. 2021 Apr:174:108756. doi: 10.1016/j.diabres.2021.108756. Epub 2021 Mar 17.

Abstract

Aims: We evaluated the clinical usefulness of a new unified glucose-insulin-potassium (GIK) regimen in a general surgical department.

Methods: Surgical patients treated under the previous diverse GIK regimens (September 2016 to August 2017) and the new unified GIK regimen (September 2017 to August 2018) were identified in records of the Clinical Data Warehouse of Seoul National University Bundang Hospital. Serial and area under the curve (AUC) glucose levels, and percentages of time within the target glucose levels were compared in propensity score matched patients in the diverse GIK regimen and in the unified GIK regimen (n = 227 in each group).

Results: The AUC of glucose at 6 h and 12 h was lower under the unified GIK regimen than the diverse GIK regimen. The percentage of target glucose levels was higher in the unified GIK regimen compared to the diverse GIK regimen (81.5% vs. 75.0%, P = 0.026), but the occurrence of hypoglycaemia did not differ significantly between groups.

Conclusions: The unified GIK regimen was more effective than the diverse GIK regimen for glycaemic control and did not increase the number of patients developing hypoglycaemia. This validated written GIK regimen can be safely used in a general surgical department.

Keywords: Diabetes mellitus; Glucose–insulin–potassium; Inpatient; Surgery.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Blood Glucose / analysis
  • Data Warehousing / statistics & numerical data*
  • Female
  • Glucose / administration & dosage
  • Glucose / standards
  • Humans
  • Hyperglycemia / etiology
  • Hyperglycemia / prevention & control*
  • Hypoglycemia / etiology
  • Hypoglycemia / prevention & control*
  • Infusions, Parenteral / standards*
  • Insulin / administration & dosage
  • Insulin / standards
  • Male
  • Potassium / administration & dosage
  • Potassium / standards
  • Research Design
  • Retrospective Studies
  • Surgical Procedures, Operative / adverse effects*

Substances

  • Blood Glucose
  • Insulin
  • glucose-insulin-potassium cardioplegic solution
  • Glucose
  • Potassium