HYPERGLYCAEMIC EFFECTS OF HARTMANN'S SOLUTION DURING SURGERY IN PATIENTS WITH MATURITY ONSET DIABETES

The metabolic effect of infusing 1.0-1.5 litre of Hartmann's solution to normal subjects and those with maturity onset diabetes has been studied during surgery. It was found that the use of Hartmann's solution after operation was associated with a 7.5 mmol litre"1 increase in plasma glucose concentration compared with an increase of 2.1 mmol litre"l in diabetic patients who received no i.v. fluids. In non-diabetic subjects who received Hartmann's solution the increase was 2.5 mmol litre"1. It is suggested that Hartmann's solution may be metabolically disadvantageous in diabetic patients. Hartmann's solution (Ringer lactate) is used com-monly during anaesthesia and surgery. Often it is given to diabetic patients as an alternative to glucose solutions. Lactate is a glucogenic precursor, and the rate of gluconeogenesis may be enhanced in diabetes, particularly in situations of stress such as surgery. Infusion of lactate may have unwanted metabolic effects in this group of patients. Therefore we have studied the metabolic response to infusion of Hart-mann's solution in maturity onset diabetic subjects, and normal subjects during surgery