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Anesth Analg 2004;99:598-602
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000122824.21065.CA

GENERAL ARTICLES

A Simple Glucose Insulin Regimen for Perioperative Blood Glucose Control: The Vellore Regimen

Ann Miriam, MD, and Grace Korula, MD

Department of Anaesthesia, Christian Medical College Hospital, Vellore, India

Address correspondence to Grace Korula, MD, Department of Anaesthesia, Christian Medical College Hospital, Vellore - 632004, India. Address e-mail to gracekorula{at}hotmail.com

In this study, we sought a simple, easily implemented method of intraoperative control of blood glucose in diabetic patients in a large multispecialty teaching hospital. The Vellore regimen, which offers the advantages of a combined glucose insulin and variable rate infusion was evaluated. For every 1 to 50-mg/dL increase in blood glucose concentration more than 100 mg/dL, 1 U of insulin was added to the injection port of a 100-mL measured volume set containing 5% dextrose in water. Hourly monitoring of blood glucose was performed. The blood glucose control was compared with the different existing techniques followed in the hospital in 204 randomized patients: 98 in the study and 106 in the control group. The study group had a mean ± SD blood glucose value of 156 ± 36 mg/dL, and the control group’s value was 189 ± 63 mg/dL (P = 0.003). The percentage of patients who were poorly controlled (outside 100 to 200-mg/dL range) decreased from 51% to 28% (no patient less than 60 mg/dL) with this regimen as compared with the control group in which it increased from 49% to 72% (10 patients less than 60 mg/dL) (P = 0.0013). We conclude that the Vellore regimen is simple, effective, and safe for intraoperative blood glucose control.

IMPLICATIONS: Intraoperative blood glucose control with 1 U of insulin for every 1–50 mg of blood glucose value more than 100 mg/dL added to 100 mL of 5% dextrose in a measured volume set was tested hourly. It is a simple and effective method and combines the advantages of combined glucose insulin and variable rate insulin infusion.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.