What insulin regimen should be used for patients with type 1 diabetes mellitus (DM) undergoing minor surgery?

Updated: Sep 13, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Blood glucose levels must be measured with a glucose meter every hour, and the rates of insulin and dextrose infusion must be adjusted accordingly to prevent hypoglycemia or persistent hyperglycemia. [142] Algorithms are available for insulin infusions, and the use of a preprinted order facilitates administration and reduces dosing errors.

For patients who are less seriously ill or are undergoing minor surgery, frequent blood glucose monitoring is not always possible. These patients may do as well with subcutaneously injected insulin. A basal bolus insulin regimen, rather than a sliding-scale regular insulin regimen, should be used in these patients.


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