On the Management of Hyperglycaemia in Critically Ill Patients Undergoing Surgery

Nomikos, Iakovos N.; Kyriazi, Maria; Vamvakopoulou, Dimitra; Sidiropoulos, Andreas; Apostolou, Athanasios; Kyritsaka, Aspasia; Athanassiou, Evangelos; Vamvakopoulos, Nicholas C.

doi:10.4021/jocmr604w

Cited by 2 publications

(2 citation statements)

References 51 publications

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“…Hyperglycemia may be encountered in critically ill nondiabetic patients scheduled for surgical interventions (21).…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of serum hemoglobin A1c and insulin levels in terms of postoperative complications in the nondiabetic patients with non-small cell lung cancer

Derdiyok¹,

Atinkaya²

2023

GSC Adv. Res. Rev.

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Background: Hemoglobin A1c and insulin levels are important parameters to indicate glucometabolic status of the patients. It is important to understand major changes in glycometabolic status so as to predict postoperative complications. In this study, we aim to assess the impact of serum hemoglobin A1c and insulin levels on postoperative morbidity in lung cancer patients. Materials and Methods: Between 2018 and 2019, 100 consecutive nondiabetic patients who underwent lung resection via thoracotomy with the indication of NSCLC were included in the study. Preoperatively all patients routinely underwent computed tomography and positron emission tomography (PET/CT), cranial magnetic resonance imaging (MRI) and pulmonary function and DLCO (Diffusing Capacity for Carbon Monoxide) tests. Preoperatively blood HbA1c, and fasting insulin levels of all patients were measured. Age, gender, BMI, insulin, HbA1c levels and postoperative complications were evaluated. Results: The higher incidence of postoperative complications was found to be related to patients with higher insulin (46.8 mIU/L vs 16.9 mIU/L, p=0.001) and HbA1c (6.22% vs 5.46%; p=0.001) levels compared with those with normal levels In patients who underwent redo surgery to treat hemorrhagic complications, higher insulin and HbA1c levels were observed (61 mIU/L, and 6.54 %, respectively , p=0.001). HbA1c and insulin levels were also higher in cases with prolonged air leak (44.7 mIU/L, and 6.25%, respectively; p=0.001). Bronchopleural fistula was observed in three patients with high insulin and HbA1c levels (60.3 mIU/L, and 6.23%, respectively; p=0.001). Conclusion: Preoperative HbA1c and fasting insulin levels are important parameters to predict postoperative morbidity in lung cancer patients.

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“…Hyperglycemia may be encountered in critically ill nondiabetic patients scheduled for surgical interventions (21).…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of serum hemoglobin A1c and insulin levels in terms of postoperative complications in the nondiabetic patients with non-small cell lung cancer

Derdiyok¹,

Atinkaya²

2023

GSC Adv. Res. Rev.

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“…Inadequate treatment of hyperglycemia leads to an increase in the prevalence of morbidity and mortality for various medical conditions as well as for surgical procedures [1][2][3]. Thus, monitoring glucose fluctuation is important in order to avoid poor metabolic control in surgical patients, even in those who do not have Diabetes Mellitus (DM).…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Role of Serum 1,5-Anhydroglucitol Concentrations as an Indicator of Hyperglycemic Changes in Diabetic and Non Diabetic Surgical Patients

Tamura¹,

Tsuneyoshi²

2013

J Anesthe Clinic Res

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Purpose: We investigated the relationship between plasma glucose and serum 1,5-anhydroglucitol (1,5-AG) concentrations in surgical patients to determine the role of 1,5-AG concentrations in perioperative glycemic control. Methods:We enrolled 57 patients (19 with and 38 without diabetes) in the study, who underwent hepatectomy under general anesthesia with sevoflurane and remifentanil. Plasma glucose and serum 1,5-AG concentrations were measured and their correlations were evaluated. Results:In all patients, plasma glucose concentrations increased significantly during hepatectomy, but serum 1,5-AG concentrations declined after surgery. Linear regression analysis revealed a weak but significant correlation between the decrease rate of 1,5-AG concentrations and the increase rate of plasma glucose concentrations. Regression analyses revealed this correlation to be more intense in patients without diabetes than in all patients, whereas no correlation was observed in patients with diabetes. These results suggest that serum 1,5-AG concentrations decrease significantly in proportion to increase in plasma glucose concentrations in patients without diabetes, but are less sensitive to such changes in patients with diabetes. Consequently, this indicates that preoperative serum 1,5-AG concentrations in patients with diabetes are too low to be influenced by glycemic fluctuations. In both patient groups, decreased 1,5-AG concentrations did not normalize until 72 h after initiation of surgery. Conclusion:Measurement of 1,5-AG concentrations may be a useful for evaluating glycemic control during anesthesia in patients with normal glycemic metabolism; however, this approach may not be as useful in patients with diabetes as in those without diabetes.

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On the Management of Hyperglycaemia in Critically Ill Patients Undergoing Surgery

Cited by 2 publications

References 51 publications

Clinical impact of serum hemoglobin A1c and insulin levels in terms of postoperative complications in the nondiabetic patients with non-small cell lung cancer

Clinical impact of serum hemoglobin A1c and insulin levels in terms of postoperative complications in the nondiabetic patients with non-small cell lung cancer

Evaluating the Role of Serum 1,5-Anhydroglucitol Concentrations as an Indicator of Hyperglycemic Changes in Diabetic and Non Diabetic Surgical Patients

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