ABSTRACT
Objective To investigate the clinical effects of a blood glycaemic control optimization programme in patients with stress hyperglycaemia after thoracic surgery.Methods One hundred and sixty patients with postoperative stress hyperglycaemia in the First Affiliated Hospital of Nanjing Medical University form July 2016 to July 2018 were randomly divided into control group and experimental group,with 80 patients in each group.Participants in the control group underwent conventional intensive insulin therapy,while participants in the experimental group underwent blood glycaemic control optimization programme.The blood glycaemic control validity index,glycemic variability index and prognostic index were compared between two groups.Results The total-dose insulin,time to reach the target range,high glycaemic index (HGI),72 h average blood glycaemic (GluAve),standard deviation of blood glycaemic (GluSD),mean amplitude of glycaemic excursions (MAGE),glycaemic instability index (GLI),variable coefficient of glycaemic (GluCv) were (69.34 ± 13.97) U,(4.14 ± 1.27) h,0.94 ± 0.30,(8.20 ± 1.06) mmol/L,(1.95 ± 0.35) mmol/L,(0.74 ± 0.27) mmol/L,35.10 ± 13.03,(22.49 ± 6.92) ％ in the experimental group.However,those index were (78.99 ± 11.46) U,(5.80 ± 2.05) h,2.27 ± 0.62,(8.30 ± 1.18) mmol/L,(2.32 ± 0.52) mmol/L,(1.15 ± 0.59) mmol/L,42.06 ± 17.09,(26.54 ± 5.14) ％ in the control group.The total-dose insulin,time to reach the target range,high glycaemic index,GluSD,MAGE,GLI,GluCv were significantly lower in the experimental group than those in control group (P ＜ 0.05).In addition,the incidence of hypoglycaemia,50％ glucose rescue and nosocomial infection were significantly decreased in the experimental group compared to the control group (P＜0.05).Conclusions Blood glycaemic control optimization programme can reduce the incidence of hypoglycemia and infection and achieve blood sugar control goal faster,safer and more effectively in patients with stress hyperglycaemia after thoracic surgery.
ABSTRACT
Objective@#To investigate the clinical effects of a blood glycaemic control optimization programme in patients with stress hyperglycaemia after thoracic surgery.@*Methods@#One hundred and sixty patients with postoperative stress hyperglycaemia in the First Affiliated Hospital of Nanjing Medical University form July 2016 to July 2018 were randomly divided into control group and experimental group, with 80 patients in each group. Participants in the control group underwent conventional intensive insulin therapy, while participants in the experimental group underwent blood glycaemic control optimization programme. The blood glycaemic control validity index, glycemic variability index and prognostic index were compared between two groups.@*Results@#The total-dose insulin, time to reach the target range, high glycaemic index (HGI), 72 h average blood glycaemic (GluAve), standard deviation of blood glycaemic (GluSD), mean amplitude of glycaemic excursions (MAGE), glycaemic instability index (GLI), variable coefficient of glycaemic (GluCV) were (69.34 ± 13.97) U, (4.14 ± 1.27) h, 0.94 ± 0.30, (8.20 ± 1.06) mmol/L, (1.95 ± 0.35) mmol/L, (0.74 ± 0.27) mmol/L, 35.10 ± 13.03, (22.49 ± 6.92)% in the experimental group. However, those index were (78.99 ± 11.46) U, (5.80 ± 2.05) h, 2.27 ± 0.62, (8.30 ± 1.18) mmol/L, (2.32 ± 0.52) mmol/L, (1.15 ± 0.59) mmol/L, 42.06 ± 17.09, (26.54 ± 5.14)% in the control group. The total-dose insulin, time to reach the target range, high glycaemic index, GluSD, MAGE, GLI, GluCV were significantly lower in the experimental group than those in control group (P<0.05). In addition, the incidence of hypoglycaemia, 50% glucose rescue and nosocomial infection were significantly decreased in the experimental group compared to the control group (P<0.05).@*Conclusions@#Blood glycaemic control optimization programme can reduce the incidence of hypoglycemia and infection and achieve blood sugar control goal faster, safer and more effectively in patients with stress hyperglycaemia after thoracic surgery.