12503
document
Clonidine premedication improves metabolic control in type 2 diabetic patients during ophthalmic surgery . BACKGROUND In stressful conditions , increasing blood glucose concentrations are closely related to an increase in catecholamines and cortisol release . Clonidine , a centrally acting alpha ( 2 ) -adrenoceptor agonist , has neuroendocrine effects , including inhibition of sympathoadrenal activity . We therefore evaluated the effect of clonidine on blood glucose control and insulin requirements during ophthalmic surgery when given as premedication in type 2 diabetic patients . METHODS After randomization , patients were premedicated with clonidine or flunitrazepam ( control ) . Patients were given insulin by continuous i.v . infusion to maintain blood glucose in the range 5.5-11.1 mmol litre ( -1 ) . Blood glucose concentrations were measured every 15 min during surgery , and hourly for 6 h after surgery . Plasma C-peptide and counter-regulatory hormones were also measured . RESULTS Glycaemia was significantly lower in the clonidine group ( P < 0.01 ) and the median amount of insulin administered was significantly reduced : clonidine group 9.0 ( interquartile range 5.1 ) units ; control 18.6 ( 10.2 ) units ; P < 0.01 ) . Plasma catecholamine concentrations were lower in patients given clonidine ( P < 0.05 ) but there was no difference in cortisol concentrations . CONCLUSION Premedication of type 2 diabetic patients with clonidine 90 min before surgery improves blood glucose control and decreases insulin requirements during ophthalmic surgery .
12504
Intervention_Pharmacological
Clonidine
12505
Intervention_Pharmacological
clonidine
12506
Intervention_Pharmacological
clonidine
12507
Intervention_Pharmacological
flunitrazepam
12508
Intervention_Pharmacological
insulin
12509
Intervention_Pharmacological
clonidine
12510
Intervention_Pharmacological
clonidine
12511
Outcome_Physical
metabolic control in type 2 diabetic patients
12512
Outcome_Physical
blood glucose control
12513
Outcome_Physical
insulin requirements
12514
Outcome_Physical
Blood glucose concentrations
12515
Outcome_Physical
Plasma C-peptide and counter-regulatory hormones
12516
Outcome_Physical
Glycaemia
12517
Outcome_Physical
median amount of insulin administered
12518
Outcome_Physical
Plasma catecholamine concentrations
12519
Outcome_Physical
cortisol concentrations .
12520
Outcome_Physical
blood glucose control
12521
Participant_Condition
type 2 diabetic
12522
Participant_Condition
ophthalmic
12523
Participant_Condition
type 2 diabetic
12524
Participant_Condition
type 2 diabetic