I N TRODUC TIONUpper gastrointestinal (UGI) cancers, specifically oesophageal and gastric cancers, account for almost 10% of new cancer cases globally and approximately 13% of cancer mortality. 1 Surgical resection, with or without neoadjuvant and adjuvant therapies, remains the basis of curative intent treatment for this cancer group. These procedures are significant and not without a high risk of complications, such as anastomotic leak and impacts on morbidity, mortality and quality of life (QOL), which are of significant concern to medical teams. [2][3][4][5] Post major UGI surgery, enteral or parenteral nutrition or the timing or type of oral diet, is a significant consideration known to affect postoperative recovery and the ability to tolerate adjuvant treatment. 5 Despite its importance, there
There is increasing evidence that skeletal muscle microvascular (capillary) blood flow plays an important role in glucose metabolism by increasing the delivery of glucose and insulin to the myocytes. This process is impaired in insulin-resistant individuals. Studies suggest that in diet-induced insulin-resistant rodents, insulin-mediated skeletal muscle microvascular blood flow is impaired post-short-term high fat feeding, and this occurs before the development of myocyte or whole-body insulin resistance. These data suggest that impaired skeletal muscle microvascular blood flow is an early vascular step before the onset of insulin resistance. However, evidence of this is still lacking in humans. In this review, we summarise what is known about short-term high-calorie and/or high-fat feeding in humans. We also explore selected animal studies to identify potential mechanisms. We discuss future directions aimed at better understanding the ‘early’ vascular mechanisms that lead to insulin resistance as this will provide the opportunity for much earlier screening and timing of intervention to assist in preventing type 2 diabetes.
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