In nondiabetic patients undergoing major abdominopelvic surgery, prophylactic glucose-insulin-potassium infusion was feasible and improved perioperative glucose control without severe hypoglycemia.

• In this pilot trial, 103 patients were randomized; 97% completed treatment, with no severe hypoglycemic episodes.
• Euglycemia occurred in 42% with prophylactic insulin versus 27% with placebo. Hyperglycemia occurred in 37% versus 48%, and treatment insulin was needed in 26% versus 45%.
• Complications were less frequent with prophylaxis (12% vs. 21%), but confidence intervals were wide and the study was not powered for outcomes.

A larger trial is feasible and should determine whether better glucose control translates into fewer surgical complications.