- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03104738
Basal Insulin Strategies Before Surgery
A Comparison of the Impact of Basal Insulin Dosing Strategies on Next-day Surgery Blood Glucose Control
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subjects who have volunteered and consented to participation in the study during their outpatient preoperative anesthesia appointment.
- Type II Diabetics taking once-daily evening basal insulin (glargine or detemir)
- Patients that will undergo general anesthesia
- Patients who have been on basal insulin for ≥ 3months
Exclusion Criteria:
- Inability to read, comprehend, and sign informed consent
- Patients with Type I Diabetes
- Patients who take short-acting insulin boluses which make up greater than 20% of their total daily insulin dose
- Patients who have been on chronic steroids ≥ 5 mg/dl prednisone daily or equivalent for ≥ 1 month within the past 12 months
- Pregnant patients
- Patients on twice-daily dosing of basal insulin
- Patient who take basal insulin in the morning
- Patients with a history of severe hypoglycemia, defined as any event in the previous year requiring assistance of another person to actively administer carbohydrate, glucagons, or other resuscitative actions
- Patients that will undergo cardiac, transplant, or brain surgeries
- Prisoners
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: 50% reduction of basal insulin dose
This is the institutional standard of care.
The evening before surgery, 20 subjects will reduce their basal insulin dose to 50%.
|
|
Experimental: 25% reduction of basal insulin dose
The evening before surgery, 20 subjects will reduce their basal insulin dose to 25%.
|
Subjects will be instructed to reduce their basal insulin dose to 75% instead of our institutional 50%. Subject must check their own blood sugar before reporting to the hospital for their surgery. If the value is less than 70 or subjects are having symptoms of hypoglycemia, subjects will be instructed to immediately ingest 4-8 oz of fruit juice (without pulp) and call their doctor or the hospital. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pre-operative Fasting Blood Glucose, as Measured by Standardized Point of Care Capillary Blood Glucose (CBG) Device in the Pre-op Holding Area.
Time Frame: Hospital arrival - Anesthesia start time. The time period did not exceed 4 hours, considering that surgeries were scheduled to be morning cases.
|
Capillary blood glucose before surgery, considering a fasting period up to 8 hours prior fasting blood glucose
|
Hospital arrival - Anesthesia start time. The time period did not exceed 4 hours, considering that surgeries were scheduled to be morning cases.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of Preoperative Hypoglycemia
Time Frame: Hospital arrival - Anesthesia start time. The time period did not exceed 4 hours, considering that surgeries were scheduled to be morning cases.
|
Capillary blood glucose level <80 mg/dl
|
Hospital arrival - Anesthesia start time. The time period did not exceed 4 hours, considering that surgeries were scheduled to be morning cases.
|
Incidence of Preoperative Hypoglycemia Requiring Ingestion of Juice Prior to Arrival to the Hospital
Time Frame: Basal insulin dose administration the evening before surgery - Hospital arrival the morning of the surgery. The time period did not exceed 12 hours, considering a fasting period up to 8 hours and a preoperative period up to 4 hours.
|
Capillary blood glucose level <70 mg/dl
|
Basal insulin dose administration the evening before surgery - Hospital arrival the morning of the surgery. The time period did not exceed 12 hours, considering a fasting period up to 8 hours and a preoperative period up to 4 hours.
|
Incidence of Preoperative Hyperglycemia
Time Frame: Hospital arrival - Anesthesia start time. The time period did not exceed 4 hours, considering that surgeries were scheduled to be morning cases
|
Capillary blood glucose level >179 mg/dl
|
Hospital arrival - Anesthesia start time. The time period did not exceed 4 hours, considering that surgeries were scheduled to be morning cases
|
Incidence of Intraoperative Hyperglycemia
Time Frame: Anesthesia start time - Anesthesia stop time. The time period did not exceed 10 hours, considering type of surgeries or procedures.
|
Capillary or arterial/venous blood glucose level >179 mg/dl
|
Anesthesia start time - Anesthesia stop time. The time period did not exceed 10 hours, considering type of surgeries or procedures.
|
Incidence of Patients Requiring Initiation of Perioperative IV Insulin Drip
Time Frame: Hospital arrival - 24 hours postoperatively.
|
Hospital arrival - 24 hours postoperatively.
|
|
Incidence of Hyperglycemia in the Post-anesthesia Care Unit (PACU) to 24 Hours Post-operatively
Time Frame: Anesthesia stop time - 24 hours postoperatively.
|
Capillary or arterial/venous blood glucose level >179 mg/dl
|
Anesthesia stop time - 24 hours postoperatively.
|
Incidence of Symptomatic Hypoglycemia Requiring Treatment in the PACU to 24 Hours Post-operatively
Time Frame: Anesthesia stop time - 24 hours postoperatively.
|
Capillary or arterial/venous blood glucose level <70 mg/dl
|
Anesthesia stop time - 24 hours postoperatively.
|
Incidence of Hypoglycemia in the PACU to 24 Hours Post-operatively
Time Frame: Anesthesia stop time - 24 hours postoperatively.
|
Capillary or arterial/venous blood glucose level <80 mg/dl
|
Anesthesia stop time - 24 hours postoperatively.
|
Incidence of Surgical Delay or Cancellation Due to Hyperglycemia
Time Frame: Hospital arrival - Surgery start date/time. The time period did not exceed 4 hours, considering that surgeries were scheduled to be morning cases
|
Hospital arrival - Surgery start date/time. The time period did not exceed 4 hours, considering that surgeries were scheduled to be morning cases
|
|
Mean 24-hour Glucose Postoperatively
Time Frame: Anesthesia stop time - 24 hours postoperatively
|
Anesthesia stop time - 24 hours postoperatively
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Barbara Rogers, MD, Ohio State University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2013H0232
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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