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Glucose Levels and Insulin Secretion in Surgery-Induced Hyperglycemia in Normoglycemic Obese Patients

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Abstract

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Medicine, Division of Endocrinology, University Hospital of Patras, Patras, 26500, Greece

    Marina Michalaki, Venetsana Kyriazopoulou, Panagiotis Mylonas & Apostolos G. Vagenakis

  2. Department of Surgery, Nutrition Support and Morbid Obesity Unit, University Hospital of Patras, Patras, 26500, Greece

    Maria-Ioanna Argentou & Fotis Kalfarentzos

  3. Department of Intensive Care Medicine, University of Leuven, B-3000, Leuven, Belgium

    Yves Debaveye

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  1. Marina Michalaki
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  2. Venetsana Kyriazopoulou
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  3. Panagiotis Mylonas
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  4. Maria-Ioanna Argentou
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  7. Apostolos G. Vagenakis
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Correspondence to Marina Michalaki.

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Michalaki, M., Kyriazopoulou, V., Mylonas, P. et al. Glucose Levels and Insulin Secretion in Surgery-Induced Hyperglycemia in Normoglycemic Obese Patients. OBES SURG 18, 1460–1466 (2008). https://doi.org/10.1007/s11695-008-9501-3

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  • DOI: https://doi.org/10.1007/s11695-008-9501-3

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