Blood Glucose Management
Newly diagnosed type 2 DM patients without standard antidiabetic
treatments before the onset of IMHA were identified (diagnostic criteria
of type 2 DM included: hemoglobin A1c [HbA1c] ≥6.5%, fasting plasma
glucose ≥126 mg/dL, and 2 hour plasma glucose≥200 mg/dL)[22] . The insulin therapy for these patients included the
insulin pump with and without long-acting and short-acting subcutaneous
insulin to achieve efficient rapid glycemic control during the acute
phase (with the help of a physician, D.J. ). The target blood
glucose level included proper blood glucose levels of fasting and
premeal states (80-130 mg/dL) and the postprandial state (less than 180
mg/dL) [1][11][22] . After achieving target glucose
control, type 2 DM patients were transitioned to scheduled subcutaneous
insulin therapy combined with the admission of oral antidiabetic
medication drugs. After TEVAR or open surgery, patients with
persistently elevated serum glucose (> 180 mg/dL) received
continuous intravenous insulin perfusion to maintain serum glucose
< 180 mg/dL during their stay in the intensive care unit and
then were transitioned to their preoperative scheduled insulin therapy
combined with oral antidiabetic drugs [1][11][22] .
The HA1c level was measured every 3 months to determine whether glycemic
targets were reached and maintained. A near-normal HbA1c
(<7%) was considered reasonable for the majority of patients[11][23] .