Nutritional and Metabolic Diseases

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Insulin

Insulin, Globin Zinc

Insulin Glargine

Zinc

Regular insulin ( Actrapid, 100 unit/mL0 Solution for injection, Insulin Human (rDNA), Novo Nordisk, will be added to parenteral nutrition to run over 24 hours as 80% of the total insulin requirement of the preceding day administered via subcutaneous sliding scale

Insulin glargine adminstred at daily night, calculated as 80% of the total insulin requirement of the preceding day from the insulin administered via subcutaneous sliding scale

80% of the insulin doses administrated via sliding scale will be administered every night as insulin glargine

Glargine Insulin

80% of the Regular insulin administrated via sliding scale will be will be added to TPN bag to run over 24 hours

Regular insulin

Hakeam A Hakeam, MS., BCPS

Hyperglycemia increases the risk of complications in surgical patients. Focus on poor glycemic control as a contributor to adverse outcomes in settings outside the intensive care unit (ICU) is often dismissed. Total parenteral Nutrition (TPN) has been used in providing surgical patients with nutrition to prevent deterioration of nutritional status. However, many diabetic patients receiving TPN develop exaggerated hyperglycemia that requires frequent insulin administration via sliding scale. Providing diabetic patient's receiving TPN basal insulin is a known strategy to aid in blood sugar control and prevention of high blood sugar spikes. Many strategies for basal insulin provision have been utilized clinically during the administration of TPN; this includes the incorporation of insulin with TPN solution or administration of long acting insulin such as glargine. However, no study has compared any of these strategies aiming for selecting the optimum modality for controlling blood glucose in diabetic surgical patient's receiving TPN. We will conduct a study to compare the efficacy of once daily insulin glargine versus continuous regular insulin incorporated TPN in controlling blood glucose in non-critically ill diabetic surgical patients receiving TPN.

Glargine Insulin vs.Continuous Regular Insulin in Diabetic Surgical Patients Receiving Parenteral Nutrition (GLUCOSE-in-PN)

Glargine Insulin Versus Continous Regular Insulin in Diabetic Surgical Patients Receiving Parenteral Nutrition (GLUCOSE-in-PN)

Assessemnt of:

1. Whole blood glucose every morning
2. The amount of subcutenous insulin adminstraed via sliding scale every 6 hours.

A target number of 60 patients to complete the study ( 30 patients in each arm) The achievement of target blood glucose based on whole blood glucose levels will be compared in two arms of the study for 5 days while on TPN. Also, the amount of insulin adminstred via sliding scale every day will be comapred as well

To assess the development of hypoglycemia in both arms of the study

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Glargine Insulin vs.Continuous Regular Insulin in Diabetic Surgical Patients Receiving Parenteral Nutrition (GLUCOSE-in-PN)	NCT02216799	Diabetic Patien...	Glargine Insuli... Regular insulin	18 Years -	King Faisal Specialist Hospital & Research Center
Glargine Insulin vs.Continuous Regular Insulin in Diabetic Surgical Patients Receiving Parenteral Nutrition (GLUCOSE-in-PN)	NCT02216799	Diabetic Patien...	Glargine Insuli... Regular insulin	18 Years -	King Faisal Specialist Hospital & Research Center

Spots Global Cancer Trial Database for diabetic patients with gastrointestinal cancer undergoing surgery and receiving parenteral nutrition