Intra-operative administration of low-dose IV glucose attenuates post-operative insulin resistance

Hiroko Fujino, Shoko Itoda, Kanako Esaki, Masanori Tsukamoto, Saori Sako, Kazuki Matsuo, Eiji Sakamoto, Kunio Suwa, Takeshi Yokoyama

研究成果: ジャーナルへの寄稿記事

3 引用 (Scopus)

抄録

Background & Aims: Insulin sensitivity often decreases after surgery in spite of normal insulin secretion, and may worsen the outcome. This post-operative insulin resistance increases according to the magnitude of surgical invasion. However, supplementation of carbohydrates before surgery attenuates the post-operative insulin re-sistance. This study aimed to investigate the effect of intra-operative administration of low-dose glucose on the post-operative insulin resistance. Methods: Patients undergoing maxillofacial surgery were randomly assigned to two groups throughout the surgical procedure: The glucose group receiving acetated Ringer solution with 1.5% glucose and the control group receiving acetated Ringer solution without glucose. Insulin resistance quantified by the mean glucose infusion rate (the glucose infusion rate) was evaluated by glucose clamp using the STG-22TM instrument on the previous day and on the next day of surgery. Blood glucose level was monitored continuously during surgery. In addition, serum insulin, ketone bodies and 3-methylhistidine were measured during periopera-tive period. Results: Patients in the glucose group (n=11) received 0.15±0.06 g/kg/h of glucose during surgery, while patients in the control group (n=11) received no glucose. In both groups, however, the mean blood glucose levels were maintained stable at less than 150 mg/dL during and after surgery. The serum ketone bodies signifi-cantly increased after surgery in the control group (p=0.0035), while it decreased significantly in the glucose group (p=0.043). The reduction rate in the glucose infusion rate was significantly lower in the glucose group, 43.3±20.7%, than that in the control group, 57.7±9.3% (p=0.041). Conclusions: Intra-operative small-dose of glucose administration may suppress ketogenesis and attenuate the post-operative insulin resistance without caus-ing hyperglycemia.

元の言語英語
ページ(範囲)400-407
ページ数8
ジャーナルAsia Pacific Journal of Clinical Nutrition
23
発行部数3
DOI
出版物ステータス出版済み - 2014

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Insulin Resistance
Glucose
Ketone Bodies
Control Groups
Insulin
Blood Glucose
Glucose Clamp Technique
Oral Surgery
Serum
Ambulatory Surgical Procedures
Hyperglycemia
Carbohydrates

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

これを引用

Intra-operative administration of low-dose IV glucose attenuates post-operative insulin resistance. / Fujino, Hiroko; Itoda, Shoko; Esaki, Kanako; Tsukamoto, Masanori; Sako, Saori; Matsuo, Kazuki; Sakamoto, Eiji; Suwa, Kunio; Yokoyama, Takeshi.

:: Asia Pacific Journal of Clinical Nutrition, 巻 23, 番号 3, 2014, p. 400-407.

研究成果: ジャーナルへの寄稿記事

Fujino, Hiroko ; Itoda, Shoko ; Esaki, Kanako ; Tsukamoto, Masanori ; Sako, Saori ; Matsuo, Kazuki ; Sakamoto, Eiji ; Suwa, Kunio ; Yokoyama, Takeshi. / Intra-operative administration of low-dose IV glucose attenuates post-operative insulin resistance. :: Asia Pacific Journal of Clinical Nutrition. 2014 ; 巻 23, 番号 3. pp. 400-407.
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title = "Intra-operative administration of low-dose IV glucose attenuates post-operative insulin resistance",
abstract = "Background & Aims: Insulin sensitivity often decreases after surgery in spite of normal insulin secretion, and may worsen the outcome. This post-operative insulin resistance increases according to the magnitude of surgical invasion. However, supplementation of carbohydrates before surgery attenuates the post-operative insulin re-sistance. This study aimed to investigate the effect of intra-operative administration of low-dose glucose on the post-operative insulin resistance. Methods: Patients undergoing maxillofacial surgery were randomly assigned to two groups throughout the surgical procedure: The glucose group receiving acetated Ringer solution with 1.5{\%} glucose and the control group receiving acetated Ringer solution without glucose. Insulin resistance quantified by the mean glucose infusion rate (the glucose infusion rate) was evaluated by glucose clamp using the STG-22TM instrument on the previous day and on the next day of surgery. Blood glucose level was monitored continuously during surgery. In addition, serum insulin, ketone bodies and 3-methylhistidine were measured during periopera-tive period. Results: Patients in the glucose group (n=11) received 0.15±0.06 g/kg/h of glucose during surgery, while patients in the control group (n=11) received no glucose. In both groups, however, the mean blood glucose levels were maintained stable at less than 150 mg/dL during and after surgery. The serum ketone bodies signifi-cantly increased after surgery in the control group (p=0.0035), while it decreased significantly in the glucose group (p=0.043). The reduction rate in the glucose infusion rate was significantly lower in the glucose group, 43.3±20.7{\%}, than that in the control group, 57.7±9.3{\%} (p=0.041). Conclusions: Intra-operative small-dose of glucose administration may suppress ketogenesis and attenuate the post-operative insulin resistance without caus-ing hyperglycemia.",
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T1 - Intra-operative administration of low-dose IV glucose attenuates post-operative insulin resistance

AU - Fujino, Hiroko

AU - Itoda, Shoko

AU - Esaki, Kanako

AU - Tsukamoto, Masanori

AU - Sako, Saori

AU - Matsuo, Kazuki

AU - Sakamoto, Eiji

AU - Suwa, Kunio

AU - Yokoyama, Takeshi

PY - 2014

Y1 - 2014

N2 - Background & Aims: Insulin sensitivity often decreases after surgery in spite of normal insulin secretion, and may worsen the outcome. This post-operative insulin resistance increases according to the magnitude of surgical invasion. However, supplementation of carbohydrates before surgery attenuates the post-operative insulin re-sistance. This study aimed to investigate the effect of intra-operative administration of low-dose glucose on the post-operative insulin resistance. Methods: Patients undergoing maxillofacial surgery were randomly assigned to two groups throughout the surgical procedure: The glucose group receiving acetated Ringer solution with 1.5% glucose and the control group receiving acetated Ringer solution without glucose. Insulin resistance quantified by the mean glucose infusion rate (the glucose infusion rate) was evaluated by glucose clamp using the STG-22TM instrument on the previous day and on the next day of surgery. Blood glucose level was monitored continuously during surgery. In addition, serum insulin, ketone bodies and 3-methylhistidine were measured during periopera-tive period. Results: Patients in the glucose group (n=11) received 0.15±0.06 g/kg/h of glucose during surgery, while patients in the control group (n=11) received no glucose. In both groups, however, the mean blood glucose levels were maintained stable at less than 150 mg/dL during and after surgery. The serum ketone bodies signifi-cantly increased after surgery in the control group (p=0.0035), while it decreased significantly in the glucose group (p=0.043). The reduction rate in the glucose infusion rate was significantly lower in the glucose group, 43.3±20.7%, than that in the control group, 57.7±9.3% (p=0.041). Conclusions: Intra-operative small-dose of glucose administration may suppress ketogenesis and attenuate the post-operative insulin resistance without caus-ing hyperglycemia.

AB - Background & Aims: Insulin sensitivity often decreases after surgery in spite of normal insulin secretion, and may worsen the outcome. This post-operative insulin resistance increases according to the magnitude of surgical invasion. However, supplementation of carbohydrates before surgery attenuates the post-operative insulin re-sistance. This study aimed to investigate the effect of intra-operative administration of low-dose glucose on the post-operative insulin resistance. Methods: Patients undergoing maxillofacial surgery were randomly assigned to two groups throughout the surgical procedure: The glucose group receiving acetated Ringer solution with 1.5% glucose and the control group receiving acetated Ringer solution without glucose. Insulin resistance quantified by the mean glucose infusion rate (the glucose infusion rate) was evaluated by glucose clamp using the STG-22TM instrument on the previous day and on the next day of surgery. Blood glucose level was monitored continuously during surgery. In addition, serum insulin, ketone bodies and 3-methylhistidine were measured during periopera-tive period. Results: Patients in the glucose group (n=11) received 0.15±0.06 g/kg/h of glucose during surgery, while patients in the control group (n=11) received no glucose. In both groups, however, the mean blood glucose levels were maintained stable at less than 150 mg/dL during and after surgery. The serum ketone bodies signifi-cantly increased after surgery in the control group (p=0.0035), while it decreased significantly in the glucose group (p=0.043). The reduction rate in the glucose infusion rate was significantly lower in the glucose group, 43.3±20.7%, than that in the control group, 57.7±9.3% (p=0.041). Conclusions: Intra-operative small-dose of glucose administration may suppress ketogenesis and attenuate the post-operative insulin resistance without caus-ing hyperglycemia.

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DO - 10.6133/apjcn.2014.23.3.10

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EP - 407

JO - Asia Pacific Journal of Clinical Nutrition

JF - Asia Pacific Journal of Clinical Nutrition

SN - 0964-7058

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