The Use of Prophylactic Insulin in Surgical Patients Without Diabetes: A Pilot Randomized, Controlled Trial.
Ann SurgJun 18, 2026 (epub)
Jamie Schnuck, Ian A Jones, Robert H Schmicker et al.
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In 30 seconds
This pilot randomized controlled trial evaluated the use of prophylactic insulin (glucose-insulin-potassium) in nondiabetic surgical patients undergoing major abdominopelvic surgery. Among 103 participants, those receiving GIK demonstrated improved glycemic control, with 42% achieving euglycemia compared to 27% in the placebo group (P <0.01).
Key findings
- 42% of patients in the GIK group achieved euglycemia compared to 27% in the placebo group (P <0.01).
- Hyperglycemia (BG >140 mg/dL) occurred in 37% of the GIK group versus 48% in the control (P <0.05).
- Fewer complications were observed in the GIK group (12%) compared to the control (21%), with an absolute risk reduction of 0.5 (95% CI: 0.2, 1.5).
Why it matters
Managing perioperative hyperglycemia is crucial for reducing morbidity and mortality in surgical patients. This study suggests that prophylactic insulin may enhance glycemic control and potentially improve clinical outcomes, warranting further investigation.