title: Does glutamine promote benefits for patients with diabetes mellitus scheduled for cardiac surgery?
abstract: BACKGROUND
  We hypothesised, that perioperative use of N(2)-L-alanyl-L-glutamine confers cardioprotection and improves insulin resistance in diabetic patients with coronary artery disease operated under cardiopulmonary bypass.
  
  
  METHODS
  This double-blind, placebo-controlled, randomised study included 64 patients with diabetes mellitus type 2 who were scheduled for on-pump coronary artery bypass graft surgery. The protocol group (32 patients) and the control group (32 patients) glutamine (0.4 g/kg/day of 20% solution of N(2)-L-alanyl-L-glutamine ("Dipeptiven(®)" Fresenius Kabi, Germany)) and placebo (0.9% NaCl), respectively. Perioperative concentration of troponin I in plasma was considered as the primary end-point. Whereas the secondary end-points were insulin resistance, insulin sensitivity, β-cell function, blood glucose, plasma triglycerides and free fatty acids concentrations. Insulin resistance, insulin sensitivity and β-cell function were measured using HOMA equation. Thermodilution method was used to measure haemodynamics in all the patients.
  
  
  RESULTS
  No differences have been found in perioperative dynamics of troponin I, insulin resistance, insulin sensitivity, β-cell function, blood glucose, plasma triglycerides free fatty acids concentrations and haemodynamics.
  
  
  CONCLUSIONS
  Our results have failed to confirm the cardioprotective properties and modulatory effect on perioperative insulin resistance that are thought to be attributable to parenteral glutamine administration in dose 0.4 g/kg/day among cardiac patients with DM operated on under CPB.
authors.affiliation: Research Institute of Circulation Pathology, Rechkunovskaya Street 15, Novosibirsk 630055, Russia.
authors.forename: Vladimir V
authors.initials: VV
authors.lastname: Lomivorotov
authors.forename: Sergey M
authors.initials: SM
authors.lastname: Efremov
authors.forename: Vladimir A
authors.initials: VA
authors.lastname: Shmirev
authors.forename: Dmitry N
authors.initials: DN
authors.lastname: Ponomarev
authors.forename: Alexandr V
authors.initials: AV
authors.lastname: Svyatchenko
authors.forename: Mihail N
authors.initials: MN
authors.lastname: Deryagin
authors.forename: Vladimir N
authors.initials: VN
authors.lastname: Lomivorotov
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Karaskov
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000097:blood / Q000628:therapy*; D004151:Dipeptides / Q000008:administration & dosage*; D004311:Double-Blind Method; D005227:Fatty Acids / Q000097:blood; D005260:Female; D005973:Glutamine / Q000008:administration & dosage*; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood; D019210:Troponin I / Q000097:blood
chemical_list: D001786:Blood Glucose; D004151:Dipeptides; D005227:Fatty Acids; D014280:Triglycerides; D019210:Troponin I; D005973:Glutamine; C054122:alanylglutamine