Is the insulin infusion automatically stopped on the third day even if the patient’s blood glucose is still bouncing above 200mg/dl or if they are unable to take PO?
A. If unable to take PO (as are many patients who remain in the ICU beyond the third postoperative day), we may continue the protocol and drip beyond the 3rd POD. If they are on the floor and not eating (because debilitated or on tube feeds), it is simply not convenient to continue the drip and we switch to SQ basal / prandial control. Note that by following the protocol closely virtually no patient’s glucose levels should be “bouncing around above 200” after the first 24 hours (let alone the third postoperative day).
