Glucose levels and insulin secretion in surgery-induced hyperglycemia in normoglycemic obese patients.
BACKGROUND
Transient hyperglycemia is commonly observed in non-diabetic subjects during surgery. We undertook this study to investigate (1) insulin secretion pattern and glucose levels during elective surgery, and (2) the role of pre-operative fasting in the development of surgery-induced hyperglycemia.


METHODS
We examined 21 severely obese normal glucose tolerant patients, who underwent bariatric surgery. From the 21 operated subjects, 14 remained fasted while seven patients received 75 g glucose the preoperative night. They sampled at baseline and from the onset of operation frequently for 9 h thereafter, for measuring serum insulin and glucose.


RESULTS
Hyperglycemia developed within 1 h from the onset of operation and lasted 9 h. The administration of 75 g glucose the preoperative night prevented surgery-induced hyperglycemia. Insulin profile analyzed by deconvolution analysis was similar between fasted patients and those who received 75 g glucose. Serum insulin was suppressed at the beginning of the surgery and reached baseline values 4 h thereafter.


CONCLUSIONS
Hyperglycemia occurred within 1 h from the beginning of surgery and sustained for at least 9 h while insulin levels are suppressed or unaltered compared to baseline values in euglycemia. The administration of 75 g glucose the preoperative night prevents surgery-induced hyperglycemia without altering the profile of insulin secretion.
Michalaki
Marina
M
Department of Medicine, Division of Endocrinology, University Hospital of Patras, Patras, 26500, Greece. mixmar@med.upatras.gr
Kyriazopoulou
Venetsana
V
Mylonas
Panagiotis
P
Argentou
Maria-Ioanna
MI
Debaveye
Yves
Y
Kalfarentzos
Fotis
F
Vagenakis
Apostolos G
AG
D000328:Adult; D015992:Body Mass Index; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D007328:Insulin / Q000097:blood* / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology; D000078790:Insulin Secretion; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D011184:Postoperative Period; D013997:Time Factors
D007328:Insulin