Continuous intravenous insulin: An evaluation in bariatric patients outside of the intensive care unit

Melanie E. Mabrey, Allison Vorderstrasse, Mary Champagne, Lisa Clark Pickett

Research output: Contribution to journalArticle

Abstract

Introduction: Bariatric surgery is being recommended for select patients with diabetes for improvement in glycemic control or possibly remission of diabetes. Diabetes remission does not happen immediately. In an effort to meet the changing glycemic control needs for bariatric surgery patients safely, a project was developed using intravenous (IV) insulin on a general surgery nursing unit. Methods: Bariatric surgery patients were identified as requiring IV insulin in the perioperative period. Nursing education was provided, and IV insulin was administered using an established tool on the general surgery floor. We retrospectively reviewed the first 10 patients treated with the protocol compared with case-matched controls. Results: The protocol was utilized in 83% of the patients meeting IV insulin criteria. No hypoglycemic events occurred. There was a significant interaction effect by treatment group and time for blood glucose during the first 24 hours postoperatively. The patients on IV insulin had a significant improvement in their blood glucose compared to the case-matched controls (p=0.011). Nursing knowledge about diabetes care demonstrated an immediate improvement in scores using a pre- and post-class paired t-test (p<0.001). However, further reassessment of knowledge level 4 months after education showed a decline in knowledge scores. Conclusions: IV insulin can be used safely and effectively in the immediate postoperative period on the general surgery nursing unit for bariatric surgery patients with diabetes. Nurses likely will require ongoing and updated knowledge in care of the inpatient with diabetes for this high risk, low frequency intervention.

Original languageEnglish (US)
Pages (from-to)172-182
Number of pages11
JournalBariatric Nursing and Surgical Patient Care
Volume7
Issue number4
DOIs
StatePublished - Dec 1 2012

Fingerprint

Bariatrics
Intensive Care Units
Insulin
Bariatric Surgery
Nursing
Blood Glucose
Perioperative Period
Nursing Education
Hypoglycemic Agents
Postoperative Period
Inpatients
Nurses
Education

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Medical–Surgical
  • Surgery

Cite this

Continuous intravenous insulin : An evaluation in bariatric patients outside of the intensive care unit. / Mabrey, Melanie E.; Vorderstrasse, Allison; Champagne, Mary; Pickett, Lisa Clark.

In: Bariatric Nursing and Surgical Patient Care, Vol. 7, No. 4, 01.12.2012, p. 172-182.

Research output: Contribution to journalArticle

@article{38e751622bb24035a73d19ad2883ed73,
title = "Continuous intravenous insulin: An evaluation in bariatric patients outside of the intensive care unit",
abstract = "Introduction: Bariatric surgery is being recommended for select patients with diabetes for improvement in glycemic control or possibly remission of diabetes. Diabetes remission does not happen immediately. In an effort to meet the changing glycemic control needs for bariatric surgery patients safely, a project was developed using intravenous (IV) insulin on a general surgery nursing unit. Methods: Bariatric surgery patients were identified as requiring IV insulin in the perioperative period. Nursing education was provided, and IV insulin was administered using an established tool on the general surgery floor. We retrospectively reviewed the first 10 patients treated with the protocol compared with case-matched controls. Results: The protocol was utilized in 83{\%} of the patients meeting IV insulin criteria. No hypoglycemic events occurred. There was a significant interaction effect by treatment group and time for blood glucose during the first 24 hours postoperatively. The patients on IV insulin had a significant improvement in their blood glucose compared to the case-matched controls (p=0.011). Nursing knowledge about diabetes care demonstrated an immediate improvement in scores using a pre- and post-class paired t-test (p<0.001). However, further reassessment of knowledge level 4 months after education showed a decline in knowledge scores. Conclusions: IV insulin can be used safely and effectively in the immediate postoperative period on the general surgery nursing unit for bariatric surgery patients with diabetes. Nurses likely will require ongoing and updated knowledge in care of the inpatient with diabetes for this high risk, low frequency intervention.",
author = "Mabrey, {Melanie E.} and Allison Vorderstrasse and Mary Champagne and Pickett, {Lisa Clark}",
year = "2012",
month = "12",
day = "1",
doi = "10.1089/bar.2012.9956",
language = "English (US)",
volume = "7",
pages = "172--182",
journal = "Bariatric Surgical Patient Care",
issn = "2168-023X",
publisher = "Mary Ann Liebert Inc.",
number = "4",

}

TY - JOUR

T1 - Continuous intravenous insulin

T2 - An evaluation in bariatric patients outside of the intensive care unit

AU - Mabrey, Melanie E.

AU - Vorderstrasse, Allison

AU - Champagne, Mary

AU - Pickett, Lisa Clark

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Introduction: Bariatric surgery is being recommended for select patients with diabetes for improvement in glycemic control or possibly remission of diabetes. Diabetes remission does not happen immediately. In an effort to meet the changing glycemic control needs for bariatric surgery patients safely, a project was developed using intravenous (IV) insulin on a general surgery nursing unit. Methods: Bariatric surgery patients were identified as requiring IV insulin in the perioperative period. Nursing education was provided, and IV insulin was administered using an established tool on the general surgery floor. We retrospectively reviewed the first 10 patients treated with the protocol compared with case-matched controls. Results: The protocol was utilized in 83% of the patients meeting IV insulin criteria. No hypoglycemic events occurred. There was a significant interaction effect by treatment group and time for blood glucose during the first 24 hours postoperatively. The patients on IV insulin had a significant improvement in their blood glucose compared to the case-matched controls (p=0.011). Nursing knowledge about diabetes care demonstrated an immediate improvement in scores using a pre- and post-class paired t-test (p<0.001). However, further reassessment of knowledge level 4 months after education showed a decline in knowledge scores. Conclusions: IV insulin can be used safely and effectively in the immediate postoperative period on the general surgery nursing unit for bariatric surgery patients with diabetes. Nurses likely will require ongoing and updated knowledge in care of the inpatient with diabetes for this high risk, low frequency intervention.

AB - Introduction: Bariatric surgery is being recommended for select patients with diabetes for improvement in glycemic control or possibly remission of diabetes. Diabetes remission does not happen immediately. In an effort to meet the changing glycemic control needs for bariatric surgery patients safely, a project was developed using intravenous (IV) insulin on a general surgery nursing unit. Methods: Bariatric surgery patients were identified as requiring IV insulin in the perioperative period. Nursing education was provided, and IV insulin was administered using an established tool on the general surgery floor. We retrospectively reviewed the first 10 patients treated with the protocol compared with case-matched controls. Results: The protocol was utilized in 83% of the patients meeting IV insulin criteria. No hypoglycemic events occurred. There was a significant interaction effect by treatment group and time for blood glucose during the first 24 hours postoperatively. The patients on IV insulin had a significant improvement in their blood glucose compared to the case-matched controls (p=0.011). Nursing knowledge about diabetes care demonstrated an immediate improvement in scores using a pre- and post-class paired t-test (p<0.001). However, further reassessment of knowledge level 4 months after education showed a decline in knowledge scores. Conclusions: IV insulin can be used safely and effectively in the immediate postoperative period on the general surgery nursing unit for bariatric surgery patients with diabetes. Nurses likely will require ongoing and updated knowledge in care of the inpatient with diabetes for this high risk, low frequency intervention.

UR - http://www.scopus.com/inward/record.url?scp=84870793304&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870793304&partnerID=8YFLogxK

U2 - 10.1089/bar.2012.9956

DO - 10.1089/bar.2012.9956

M3 - Article

AN - SCOPUS:84870793304

VL - 7

SP - 172

EP - 182

JO - Bariatric Surgical Patient Care

JF - Bariatric Surgical Patient Care

SN - 2168-023X

IS - 4

ER -