i.v. glucose and insulin therapy

Last reviewed 01/2018

An example protocol is shown - protocols are likely to vary between hospitals and the locally agreed protocol should be followed:

  • discontinue previous diabetic therapy
  • give 1 litre of 10% dextrose 12 hourly with a 20 mmol potassium supplement
  • the administration of insulin by infusion pump should be regulated according to the blood glucose level and should aim to keep glucose concentrations between 5 and 10mM:

  • Blood sugar concentration; insulin infusion rate
  • 5 mM; 1U/hr
  • 5-10 mM; 2 U/hr
  • 10-20 mM; 3 U/hr
  • > 20 mM; 4 U/hr

  • blood glucose should be measured regularly (and the insulin infusion rate altered accordingly):

  • When to measure blood glucose; Frequency of measurement
  • Preoperatively; At least once
  • Intraoperatively; Hourly
  • Postoperatively; 3-4 hourly

Intravenous glucose control should be continued until the patient is eating again. Thereafter the normal diabetic regime may be recommenced.