What is the Alberti regimen?
What is the Alberti regimen?
Quick Reference. (GIK regime) a method for controlling blood-sugar levels in diabetic patients who are being fasted for whatever reason. It involves infusing a solution of glucose (G), insulin (I), and potassium (K) chloride intravenously over a standard time period.
When is Albertis regimen used?
The recommendations for type 1 diabetic patients were to use the Alberti regimen in all patients undergoing surgery and to continue the infusion until the patient was eating (ambulatory surgery was in its infancy in 1979). Practical aspects of the use of the combined regimen were discussed in detail.
How do you give GKI?
Glucose potassium insulin (GKI) infusion – This is an alternative regime where 500ml of 10 per cent dextrose, 10mmol potassium chloride and 10 units of insulin are all given in the same infusion at a rate of 100ml/hour. CBG levels should be measured hourly to ensure the glucose remains within the target of 7-11mmol/l.
When is GKI used?
Use a GKI for tablet-controlled diabetes with blood glucose outside 4-12mmol range, or if they are likely to be fasted postoperatively.
Why management of diabetes is important in surgical patient?
Diabetes is associated with increased requirement for surgical procedures and increased postoperative morbidity and mortality. The stress response to surgery and the resultant hyperglycemia, osmotic diuresis, and hypoinsulinemia can lead to perioperative ketoacidosis or hyperosmolar syndrome.
Is Ringer lactate safe in diabetes?
Ringer’s lactate can be used as a safe alternative intravenous fluid in the perioperative period in patients with well- controlled diabetes mellitus receiving spinal anaesthesia.
When to use the Alberti regimen in surgery?
The recommendations for type 1 diabetic patients were to use the Alberti regimen in all patients undergoing surgery and to continue the infusion until the patient was eating (ambulatory surgery was in its infancy in 1979). Practical aspects of the use of the combined regimen were discussed in detail.
What kind of insulin is used in the Alberti regimen?
The Alberti regimen has been superceded in many centres by the use of separate infusions of insulin (usually 1 U ml −1) and glucose with or without potassium. 2 Although the separate infusions offer greater flexibility, they lack the inherent safety of the combined regimen.
When did Alberti infuse potassium in diabetics?
In 1979, the British Journal of Anaesthesia published an article by Alberti and Thomas 1 in which they introduced the i.v. infusion of a premixed bag of glucose–insulin–potassium for the metabolic management of diabetic patients in the perioperative period.
What did Alberti and Thomas Say about diabetes?
Alberti and Thomas summarized the aims of treatment of diabetes as the rapid recovery from surgery with minimal metabolic problems, such as hypoglycaemia and ketoacidosis, and minimal complications such as infection, delayed wound healing, and cardiovascular events.