In this study we will determine the proper method for transitioning patients from a continuous insulin infusion to periodic injections of a newer long-acting insulin called detemir (Levemir).
High sugar (glucose) is common after surgery, even in patients who do not have diabetes. High glucose contributes to severe hospital complications and even death. Insulin infusions appear to reduce this risk, but are generally only continued for a few days after surgery. In this study, we will determine the proper method for transitioning patients from a continuous insulin infusion to periodic injections of a newer long-acting insulin called detemir (Levemir). 90 patients who have undergone recent open heart surgery and are requiring an insulin infusion will be enrolled. They will be randomly assigned to one of three doses of detemir, which consists of 50%, 65%, or 80% of the total daily insulin infusion requirement in the fasting state. Subjects will also receive identical mealtime coverage according to the amount of carbohydrate (glucose) that is ingested. It is expected that the high dose group will achieve superior glycemic control without excessive hypoglycemia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
82
The Ohio State University
Columbus, Ohio, United States
Patients With Morning (AM) Glucose Between 80-130 mg/dl on Day 2 and 3
Number of patients with a morning glucose between 80-130 mg/dl on day 2 and day 3
Time frame: day 2, day 3
Patients With Hypoglycemia (Defined as Glucose <65 mg/dl)
Number of patients with hypoglycemia (defined as glucose \<65 mg/dl)
Time frame: 48 hours
Reversion to Intravenous Insulin for Failure of Glycemic Control
Number of participants who went back on intravenous insulin for failure of glycemic control.
Time frame: 72 hours
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