PSUN173 Factors determining insulin dose while transitioning from intravenous insulin infusion to subcutaneous insulin in patients with type 2 diabetes following cardiac bypass surgery.

INTRODUCTION: In patients with type 2 diabetes undergoing cardiac bypass surgery, data regarding the factors predicting insulin dose while transitioning from intravenous insulin infusion to subcutaneous insulin are scarce. This study was therefore planned to determine the factors that predict postoperative subcutaneous insulin dose, basal-to-bolus insulin ratio and the factors determining this ratio. METHODS: This is a single centre prospective observational study in 280 consecutive cardiac bypass surgery patients with type 2 diabetes at a tertiary care facility in India. RESULTS: In linear regression analysis, the subcutaneous insulin dose following cardiac surgery was determined by glycated hemoglobin (HbA1c) at admission (beta 0.34, p <0.0001), insulin dose before surgery (beta 0.33, p <0.0001), sulphonylurea (beta 0.19, p = 0.002), and metformin doses (beta 0.14, p = 0.017) before surgery, and intravenous insulin dose (beta 0.11, p =0.041) after surgery. The basal-to-bolus ratio of insulin after surgery was 0.9, and was negatively predicated by serum creatinine levels and age, and positively by body weight of the patients. CONCLUSIONS: In our study, post-surgery subcutaneous insulin dose after transitioning from intravenous insulin infusion depends on several factors, such as HbA1c and insulin dose before surgery, metformin and sulfonylurea use before surgery and intravenous insulin infusion dose during surgery. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.