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

Tae Jung Oh, Ji-Hyung Kook, Se Young Jung, Duck-Woo Kim, Sung Hee Choi, Hong Bin Kim, Hak Chul Jang

Journal: Diabetes research and clinical practice 2021;174():108756

PMID: 33741353

Full Text on Elsevier Science View on PubMed

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.

Address: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.; Office of eHealth Research and Business and Center for Medical Informatics, Seongnam, South Korea; Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.; Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea; Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. Electronic address: [email protected].

DOI: 10.1016/j.diabres.2021.108756

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MeSH Terms: Aged, Blood Glucose, Data Warehousing, Female, Glucose, Humans, Hyperglycemia, Hypoglycemia, Infusions, Parenteral, Insulin, Male, Potassium, Research Design, Retrospective Studies, Surgical Procedures, Operative