Perioperative insulin and glucose infusion maintains normal insulin sensitivity after surgery

Jonas O. Nygren, Anders Thorell, Mattias Soop, Suad Efendic, Kerstin Brismar, Fredrik Karpe, K. S. Nair, Olle Ljungqvist

Research output: Contribution to journalArticle

87 Scopus citations

Abstract

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 insulin group (+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.

Original languageEnglish (US)
Pages (from-to)E140-E148
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume275
Issue number1 38-1
DOIs
StatePublished - Jul 1998

Keywords

  • Glucose metabolism
  • Glucose-clamp technique
  • Insulin resistance

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Physiology
  • Physiology (medical)

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