[Effect of intensive insulin therapy on the clinical results of postoperative patients with gastric cancer].
OBJECTIVE
To investigate the influence of intensive insulin therapy on the results of postoperative patients with gastric cancer.


METHODS
Forty-six patients with gastric cancer underwent radical operation were randomly divided into two groups: intensive group (n=23, to control blood glucose at 4.4 to 6.1 mmol/L) and conventional group (n=23, to control blood glucose at 10.0 to 11.1 mmol/L). Fasting blood glucose( FBG), fasting insulin (FINS), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and C reaction protein (CRP) in 46 patients were detected dynamically during perioperative period. Insulin resistance index (HOMA-IR) were calculated using Homeostasis Model Assessment (HOMA) to evaluate insulin sensitivity. Postoperative complications and other clinical data were recorded.


RESULTS
No hypoglycemia occurred in the two groups. Compared with conventional group, morbidity and postoperative duration of fever, antibiotic use and the length of hospital stay in intensive group were significantly reduced (P < 0.05). On the day 1 and 3 after surgery, HOMA-IR and serum levels of TNF-alpha, IL-6 and CRP in patients of intensive group were significantly lower than those in conventional group (P < 0.05).


CONCLUSIONS
Intensive insulin therapy could counteract the state of high-inflammation and then improve the outcome of postoperative patients.
Cao
Shou-gen
SG
Department of General Surgery, the Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, China.
Zhou
Yan-bing
YB
Zhang
Cai-kun
CK
Chen
Dong
D
Yu
Yun-yun
YY
Lu
Lian-fang
LF
D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood / Q000627:therapeutic use*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein