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Perioperative insulin and glucose infusion maintains normal insulin sensitivity after surgery
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Department of Surgery, Karolinska Hospital, Stockholm, Sweden; Huddinge Univ. Hospital, Huddinge, Sweden.
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Dept. Endocrinology and Diabetes, Karolinska Hospital, Stockholm, Sweden.
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1998 (English)In: American Journal of Physiology, ISSN 0002-9513, E-ISSN 2163-5773, Vol. 275, no 1 Part 1, p. E140-E148Article in journal (Refereed) Published
Abstract [en]

Elective surgery was performed after overnight fasting, a routine that may affect the metabolic response to surgery. We investigated the effects of insulin and glucose infusions before and during surgery on postoperative substrate utilization and insulin sensitivity. Seven patients were given insulin and glucose infusions 3 h before and during surgery (insulin group), and a control group of six patients underwent surgery after fasting overnight. Insulin sensitivity and glucose kinetics (D-[6,6-2H2]glucose) were measured before and immediately after surgery using a hyperinsulinemic, normoglycemic clamp. Glucose infusion rates and whole body glucose disposal decreased after surgery in the control group (-40 and -29%, respectively), whereas no significant change was found in the insulingroup (+16 and +25%). Endogenous glucose production remained unchanged in both groups. Postoperative changes in cortisol, glucagon, fat oxidation, and free fatty acids were attenuated in the insulin group (vs. control). We conclude that perioperative insulin and glucose infusions minimize the endocrine stress response and normalize postoperative insulin sensitivity and substrate utilization.

Place, publisher, year, edition, pages
American Physiological Society , 1998. Vol. 275, no 1 Part 1, p. E140-E148
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Physiology
Identifiers
URN: urn:nbn:se:oru:diva-63886ISI: 000074727300020PubMedID: 9688885Scopus ID: 2-s2.0-0031858103OAI: oai:DiVA.org:oru-63886DiVA, id: diva2:1171082
Note

Funding agencies:

NCRR NIH HHS RR-00585 

NIDDK NIH HHS R01-DK-41973 

Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2018-02-05Bibliographically approved

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Ljungqvist, Olle

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