Methods: After ethics committee approval, 274 cases undergoing elective CPB surgery were included in this study and divided into two groups as diabetic (n=112) and non-diabetic (n=162) patients. Standard anesthetic, surgical, and CPB protocols were used in all patients. In accordance with the routine protocol of our clinic, diabetic patients received 5% dextrose by intravenous infusion at a fixed rate of 1.5 mg/kg/hr and insulin infusion. The insulin (50 units of regular insulin in 50 mL normal saline) infusion rate was adjusted according to the formula [units/hr= blood glucose (mg/dL)/100] that is used as our clinic's routine protocol. Blood glucose levels were measured before, during, and after CPB. The demographic data, duration of cross-clamping and CPB, intraoperative fluid management, and the amount of blood transfusions were recorded.
Results: The demographic characteristics of the diabetic group and the non-diabetic group were similar. There was a statistically significant increase in the glycemia levels of both groups from the baseline measurement values. The increase observed between the first and last glycemia level measurements was 37.16% and 43.04% in the diabetic and nondiabetic patients, respectively. It was observed that statistically significant increases from the baseline occurred in both groups; however, the glycemia levels of the group with diabetics showed less of an increase than in the non-diabetic group.
Conclusion: Our routine insulin-dextrose infusion protocol seems to be reliable for controlling blood glucose levels in diabetic patients who undergo CPB.