Study On The Relationship Between Preoperative Hypoglycemic Regimen And Postoperative Blood Glucose Fluctuation In Patients With Colorectal Cancer Complicated With Diabetes

OBJECTIVE: To compare the effects of different preoperative hypoglycemic regimens on blood glucose control level after total parenteral nutrition in patients with colorectal cancer and diabetes.Methods: A retrospective analysis was performed on patients with colorectal cancer and diabetes who underwent surgical treatment between May 2018 and May 2019 in our hospital.We screened out patients who had venous blood glucose,blood glucose,and glycated hemoglobin at normal levels before surgery and who received total parenteral nutrition support three days after surgery.Such patients follow the perioperative nutritional support requirements:(1)Glucose control of glucose-containing solutions according to sugar: insulin =(4-6)g: 1U;(2)blood glucose monitoring at postoperative q6 h,(3)if random blood glucose levels> 11.1 mmol / L,insulin supplementation immediately.Inquire through the medical record system doctor's order to determine whether additional insulin is used to supplement hypoglycemia after surgery,and use this as a standard for poor blood sugar control.Count the number of insulin supplements and the corresponding hypoglycemic programs.Analyze the relationship between different preoperative hypoglycemic regimens and postoperative insulin supplementation for hypoglycemic patients.Results: A total of 312 colorectal cancer patients with diabetes were selected,and 174 met the inclusion criteria.They were classified according to the mechanism of hypoglycemic regimen:(1)16 cases of metformin alone,5 cases of insulin supplementation;(2)29 cases of metformin +insulin secretagogue,12 cases of insulin supplementation;(3)14 cases of metformin + ?-glycosidase inhibitor,5 cases of insulin supplementation;(4)9 cases of metformin + insulin secretagogue + thiazolidinedione,6 cases of insulin supplementation;(5)biguanide + insulin 16 For example,6cases of insulin supplementation;(6)23 cases of insulin secretagogue alone,12 cases of insulin supplement;(7)22 cases of insulin secretagogue+ thiazolidinedione,8 cases of insulin supplement;(8)insulin secretagogue + ?-glycosidase 17 cases of inhibitors,10 cases of insulin supplementation;(9)28 cases of insulin control patients,13 cases of insulin supplementation.Conclusions: 1.Under the premise that blood glucose is controlled,the number of postoperative insulin supplementation hypoglycemic patients using metformin or thiazolidinedione-based hypoglycemic regimen is less than that of insulin secretagogue alone and insulin secretagogue combined with acarbose Sugar patients.2 Under the premise of glycemic control,there is no obvious correlation between the number of preoperative hypoglycemic drugs and postoperative insulin supplementation.