Dextrose drip and variable rate insulin infusion

(1) Give normal insulin on the night before the operation

(2) Early on the day of operation start an infusion of 10% dextrose, add 20mmol potassium chloride to each litre, and run at a constant rate appropriate to the patient's fluid requirement, usually 100ml/h

(3) Make up a solution of soluble insulin 1 unit/ml saline in a syringe and infuse intravenously by a line piggybacked to the intravenous drip by using a syringe pump. The infusion rate should normally be as shown in regimen 1, but in resistant cases use regimen 2 or 3

Blood glucose

Soluble insulin infusion rate

Regimen 1

Regimen 2

Regimen 3

< 4 mmol/l


1 unit/h

2 unit/h

4-10 mmol/l



8 unit/h

10-15 mmol/l


8 unit/h

16 unit/h

15-20 mmol/l

6 unit/h

12 unit/h

24 unit/h

> 20 mmol/l


Blood glucose is measured preoperatively and then two hourly until stable, then six hourly

Regimen 1 is satisfactory for most cases; very severely ill patients, shocked patients, and those receiving steroids, salbutamol, or dopexamine infusions may need higher dose infusions, such as regimens 2 or 3, occasionally even more.

Do not stop the insulin infusion since intravenous insulin lasts for only a few minutes

Only if the patient becomes frankly hypoglycaemic (blood glucose < 2-0 mmol/l) should insulin be stopped for up to 30 minutes

Supplements For Diabetics

Supplements For Diabetics

All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.

Get My Free Ebook


  • hunter
    How did dextrose help with patient on variable rate insulin infusion?
    4 months ago

Post a comment