[Skip to Content]
[Skip to Content Landing]
February 14, 1977

Insulin in the Management of the Diabetic Surgical Patient: Continuous Intravenous Infusion vs Subcutaneous Administration

Author Affiliations

From the Diabetes Service, Rancho Los Amigos Hospital, Downey, Calif, and the University of Southern California School of Medicine, Los Angeles.

JAMA. 1977;237(7):658-660. doi:10.1001/jama.1977.03270340044017

A prospective randomized study comparing constant intravenous infusion of regular, low-dose insulin versus conventional subcutaneous administration of neutral protein Hagedorn (NPH) insulin in insulin-requiring patients undergoing orthopedic procedures under general anesthesia was undertaken. The degree of diabetic control was better in those receiving constant 2 units/hour of regular insulin than in those receiving two thirds of daily maintenance doses of NPH insulin. However, in two of eight patients receiving 2 units/hour, decreased insulin infusion rates and increased dextrose infusion rates were required to avoid hypoglycemia. Preoperative NPH insulin and 1 unit/hour insulin administration resulted in equivalent diabetic control.

(JAMA 237:658-660, 1977)