Glucose Homeostasis in the Postoperative State

Abstract

The postoperative period is a unique and complex state caused by the controlled injury of surgery, anesthetic agents, and starvation. These factors produce profound physiologic and metabolic alterations which subject homeostatic mechanisms to stress. The glueose-insulin feedback system operates in an altered milieu of increased catecholamines and corticosteroids, liver glycogen depletion and changes in perfusion patterns. We have examined the response to insulin in the early and later postoperative periods to determine insulin clearance, hepatic glucose output and peripheral utilization of glucose.