INTENSIVE INSULIN THERAPY IN SURGICAL PATIENTS WITH TYPE 2 DIABETES MELLITUS

The aim of the investigation was to assess the efficiency of intensive insulin therapy in surgical patients with type 2 diabetes mellitus (DM 2) in intensive care unit in relation to the effect on postoperative clinical progression and 90-day survival of patients. Materials and Methods. The study included 89 patients hospitalized in intensive care unit for various surgical pathologies, with DM 2 in past medical history. On admission the patients were divided into 4 groups in a random manner. First 72 h target glycemia range for groups 1 and 2 was glucose level of 6.5-8.5 mmol/L, and for groups 3 and 4 - 8.6-11.0 mmol/L. Continuous insulin infusion was chosen for the treatment of groups 1 and 3 for the same period, the patients of groups 2 and 4 were given divided insulin injections. The severity of all patients was studied first 24 h and 72 h after inpatient treatment according to APACHE II, SAPS II. Conclusion. In ICU patients suffering from type 2 DM with various surgical pathology, target glycemic levels of 6.5-8.5 and 8.6-11.0 within the frame of one insulin therapy method are not associated with the differences in relation to the severity and outcome of the main pathology. Glycemic control in target range of 6.5-11.0 mmol/L by intravenous insulin infusion has the advantage over divided insulin subcutaneous injections regarding the severity and outcome of the main pathology.