Evaluation of thrice-daily injections of insulin Lispro Mix 50/50 versus basal-bolus therapy in perioperative patients with type 2 diabetes
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The purpose of this study was to compare two perioperative insulin therapies [thrice-daily injections of insulin Lispro Mix 50/50 (3X-Mix50) versus basal-bolus injections (BBT)] in type 2 diabetic patients who were judged by attending endocrinologists to require intensive insulin treatment before surgery.
Materials and methods
A retrospective analysis was performed on data collected from 47 surgical patients hospitalized at Obihiro-Kosei General Hospital and treated with BBT (n = 27) or 3X-Mix50 (n = 20) for 1 year.
Patient baseline characteristics (age, duration of diabetes, BMI, FPG and HbA1c) were similar between therapeutic groups. Both therapies achieved target glycemic control for surgery in 9 days on average. There was no significant difference in average pre-meal or bedtime blood glucose levels. The total daily insulin dose before surgery was similar (28.3 U in BBT vs. 24.8 U in 3X-Mix50, p = 0.1146). No episodes of severe hypoglycemia occurred, and the number of episodes of mild hypoglycemia during the perioperative period was similar. No surgical complications such as infection occurred, and one orthopedic surgery-related issue occurred in each therapeutic group.
We showed 3X-Mix50 and BBT were comparable in terms of glycemic control, total insulin dose, and incidence of hypoglycemia and perioperative complications. While comparable to classical BBT therapy, the 3X-Mix50 provides a convenient alternative method for maintaining glycemic control in patients with type 2 diabetes during the perioperative period.
KeywordsType 2 diabetes Insulin Lispro Mix 50/50 Basal-bolus therapy Perioperative period Surgical complications
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