Comparison of Two Short-acting Insulin Formulations in the Management of Blood Glucose in Undergoing Coronary Artery Bypass Graft Surgery Patients

Background: Postoperative high blood glucose levels can affect the prognosis following coronary artery bypass graft (CABG). Although actrapid and fast-acting insulin aspart (FIASP) are approved for intravenous (IV) use, very limited data on their safety and efficacy in patients undergoing cardiac procedures are available. This study compared the efficacy of IV actrapid and FIASP in maintaining blood glucose levels in patients with diabetes undergoing CABG. Methods: In this retrospective, single-center study, people with diabetes who underwent CABG surgery were included in the study. Data on patients undergoing CABG surgery who received injection actrapid or FIASP perioperatively were collected to control blood glucose. The target blood glucose level was 150–180 mg/dl, and the sliding scale therapy was followed to maintain the glucose levels within this range. Blood glucose level <70 mg/dl was considered hypoglycemia. Data were collected at baseline (day 0) and on days 2 and 6 after the surgery. Results: The study included 100 patients, 50 in each of the FIASP-treated group and the actrapid-treated group. Fasting and mean blood glucose levels significantly decreased in both FIASP and actrapid groups from day 2 to day 6 after surgery. The total dose of insulin required daily was significantly lower in the FIASP group despite the high inotropic levels at baseline. There was no statistically significant difference in the fasting and mean blood glucose levels between the FIASP and actrapid groups. Conclusion: FIASP and actrapid safely and effectively control the blood glucose levels post CABG; however, the units required for FIASP were less than those required for actrapid, and patients in the FIASP group require minimal insulin at discharge.