Preoperative Hypoglycemia in a Patient Receiving Insulin Detemir

被引:1
作者
Olson, Ronald P. [1 ]
Bethel, M. Angelyn [2 ,3 ]
Lien, Lillian [2 ,3 ]
机构
[1] Duke Univ, Dept Anesthesiol, Preoperat Screening Unit, Durham, NC 27710 USA
[2] Duke Univ, Div Endocrinol, Durham, NC 27710 USA
[3] Duke Univ, Dept Med, Durham, NC 27710 USA
关键词
MYOCARDIAL-INFARCTION; DIABETES-MELLITUS; MORTALITY; GLARGINE; THERAPY; VARIABILITY; MANAGEMENT; INFUSION;
D O I
10.1213/ane.0b013e3181a2a777
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The insulin regimen of a Type 2 diabetic presenting for surgery had been changed recently from a 70/30 mixture of insulin aspart protamine and aspart to insulin detemir and insulin glulisine. Preoperative instructions were to take the usual dose of basal, but none of the short-acting insulin. On the morning of surgery, the patient's blood glucose was low and remained so despite IV dextrose administration. A review of the basal insulin dose revealed that it had been inappropriately increased to control elevated postprandial glucose. Doses of basal insulin in excess of basal requirements will cause hypoglycemia in the fasting state. (Anesth Analg 2009;108:1836-8)
引用
收藏
页码:1836 / 1838
页数:3
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