Clinical Outcome of Basal-Bolus Insulin Regimes in Type 2 Diabetics Undergoing Surgery

India is leading the world in number of diabetics and has earned a dubious distinction of being termed as the diabetic capital of the world. One third of the patients undergoing surgery are diabetics. It is a known fact that diabetics undergo surgery at a higher rate than non-diabetics and are more prone to various adverse outcomes. Many treatment modalities are employed for metabolic control in diabetics undergoing surgery during perioperatve period with an aim to reduce the morbidity and mortality. Among such insulin regimes, the basal-bolus subcutaneous insulin regimen is thought to be more physiological approach to control the hyperglycaemia in hospitalized patients. In basal-bolus insulin regime long acting basal insulin is given to control the hyperglycaemia overnight and short acting bolus insulin is given to control the hyperglycaemia after meals. Though the basal-bolus insulin regimes are employed in non-surgical situations for glycaemia control. However, there is paucity of scientific literature regarding the clinical outcome of long lasting basal insulin and rapid acting mealtime insulin regimes in surgical situations. Hence, it was found worthwhile to study the clinical outcomes of two subcutaneous split-mixed basal/bolus insulin regimes in diabetics undergoing surgery. Therefore, this study has evaluated the clinical outcome of two subcutaneous split-mixed regimes: Glargine as basal and Lispro as bolus insulin versus Detemir as basal and Aspart as bolus insulin in type 2 diabetics undergoing surgery.