Glucose levels and insulin secretion in surgeryinduced hyperglycemia in normoglycemic obese patients

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Glucose Levels and Insulin Secretion in Surgery-Induced Hyperglycemia in Normoglycemic Obese Patients Marina Michalaki, Venetsana Kyriazopoulou, Panagiotis Mylonas, Maria-Ioanna Argentou, Yves Debaveye, Fotis Kalfarentzos and Apostolos G. Vagenakis Obesity Surgery, 2008, Epub ahead of print

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Introduction Transient hyperglycemia is commonly observed in non-diabetic subjects during surgery. We undertook this study to investigate: insulin secretion pattern and glucose levels during elective surgery the role of pre-operative fasting in the development of surgery-induced hyperglycemia.

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Methods We examined 21 severely obese normal glucose tolerant patients, who underwent bariatric surgery. From the 21 operated subjects, 14 remained fasted while 7 patients received 75 grams glucose the preoperative night. They sampled at baseline and from the onset of operation frequently for 9 hours thereafter, for measuring serum insulin and glucose.

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Flow chart of the study design

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RESULTS

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Serum glucose levels in operated patients p<0.001, ANOVA for repeated measures. Values expressed as mean±1SE

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Serum insulin levels every 10 minutes from the onset of operation and for 9 hours thereafter

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Insulin/glucose ratio in operated patients p<0.05, ANOVA for repeated measures. Values expressed as mean±1SE

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Conclusions Hyperglycemia occurred within one hour from the beginning of surgery and sustained for at least 9 hours while insulin levels are suppressed or unaltered compared to baseline values in euglycemia. The administration of 75grams glucose the pre-operative night prevents surgery-induced hyperglycemia without altering the profile of insulin secretion.

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