The effect of hyperalimentation solutions providing near-normal caloric intake on ketone production was evaluated in two diabetic patients postoperatively. The first served as his own control. A diabetic requiring 60 units of insulin daily received hyperalimentation fluids by subclavian catheter after one procedure and the usual intravenous fluids after the second operation. High-caloric intravenous solutions reduce the risk of postoperative ketosis. The results of the initial experiment in nature were applied to another severe diabetic following subtotal gastrectomy and transverse colectomy.
Lazarus HM. Prevention of Postoperative Ketosis in the DiabeticUse of High-Caloric Intravenous Solutions. Arch Surg. 1973;106(6):858-860. doi:10.1001/archsurg.1973.01350180092026