title: Perioperative Hyperglycemia and Glucose Variability in Gynecologic Laparotomies.
abstract: BACKGROUND
  The glycemic response and its relation to postoperative complications following gynecologic laparotomies is unknown, although these surgeries carry a substantial risk for postoperative morbidity. Therefore, our objective was to assess the prevalence of perioperative hyperglycemia and glucose variability in women undergoing a gynecologic laparotomy.
  
  
  METHODS
  In this prospective cohort study, capillary glucose was measured every hour during the perioperative period. The primary outcome measures were the proportion of patients with postoperative hyperglycemia (glucose >180 mg d l(-1)) and the glucose variability in the intra- and postoperative period. Postoperative complications were assessed as secondary outcome measure.
  
  
  RESULTS
  We included 150 women undergoing a gynecologic laparotomy. Perioperative hyperglycemia occurred in 33 patients without diabetes (23.4%) and in 8 patients with diabetes (89%). Glucose variability was significantly higher (mean absolute glucose change [MAG] 11 mg dl(-1) hr(-1) [IQR 8-18]) in the intraoperative compared to the postoperative period (MAG 10 mg dl(-1) hr(-1) [IQR 3-16], P = .03). Neither hyperglycemia nor glucose variability was associated with postoperative complications.
  
  
  CONCLUSIONS
  Hyperglycemia and glucose variability seem to be a minor problem during gynecologic laparotomy. Based on the current data, we would not advocate standardized glucose measurements in every patient without diabetes undergoing gynecologic laparotomy.
authors.affiliation: Department of Anaesthesiology, Academic Medical Centre, Amsterdam, Netherlands j.a.polderman@amc.uva.nl.
authors.forename: Jorinde A W
authors.initials: JA
authors.lastname: Polderman
authors.affiliation: Department of Anaesthesiology and Laboratory of Experimental Intensive Care and Anaesthesiology, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: Markus W
authors.initials: MW
authors.lastname: Hollmann
authors.affiliation: Department of Endocrinology, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: J Hans
authors.initials: JH
authors.lastname: DeVries
authors.affiliation: Department of Anaesthesiology and Laboratory of Experimental Intensive Care and Anaesthesiology, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Preckel
authors.affiliation: Department of Anaesthesiology, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hermanides
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology* / Q000209:etiology; D007813:Laparotomy / Q000009:adverse effects; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose
keywords: glucose variability; hyperglycemia; perioperative period; postoperative complications