Summary
Substitution of insulin for a dietary regime with or without oral hypoglycaemic agents prior to operation is, despite its general use, often not satisfactory because of lack of time and leads frequently to hypoglycaemia and sometimes to excessive insulin-antibody production. We therefore administered 1.0 g of Tolbutamidei.v. together with at least 100 g of carbohydrates per day to 36 non-insulin dependent diabetic patients, and compared the results with those of 28 similiar cases switched to insulin preoperatively in the usual way (I), and those of 27 patients receiving insulin before, during and after the operation (II). Interventions in the group on Tolbutamide i.v. (III) were more severe and lasted longer than those in the control groups. Blood-sugar levels on the operation day rose to 209 ± 76 mg% in the Tolbutamide group, (Control group I 203 ± 57, II 186 ± 52). Hypoglycaemia was observed in the control groups only. The method proposed avoids unnecessary insulin treatment and its consequences, and can be recommended, with correct selection of patients, for further evaluation during minor and more extensive operations.
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Schmitt, H., Liebermeister, H., Sardo, G.L. et al. Behandlung von Altersdiabetikern während der Operation mit intravenösen Tolbutamidgaben. Diabetologia 4, 307–308 (1968). https://doi.org/10.1007/BF01309906
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DOI: https://doi.org/10.1007/BF01309906