Post-operative insulin resistance
Abstract
Post-operative insulin resistance (IR) is a recognised marker of surgical stress. However, the reasons underlying post-operative IR and its clinical value are still unclear. IR has been described as a pathological condition, in which organs and tissues fail to respond to the hormone insulin, resulting in acute hyperglycaemia. Post-operative IR in patients without type 2 diabetes has been identified as an independent, negative predictor of post-operative outcome. Studies have shown a direct relationship between post-operative morbidity (including complications from infection) and total mortality in patients with acute hyperglycaemia compared with diabetic patients. IR and stress-induced hyperglycaemia in the early post-operative period may be corrected by insulin infusion; however, this has often been associated with hypoglycaemia. Detection and modification of risk factors in the pre- and intra-operative periods may decrease the frequency of IR and hyperglycaemia and eliminate the use of insulin. In this literature review, the mechanisms underlying the development and prevention of post-operative IR, and its clinical value are discussed. This study demonstrates the relationship between IR and post-operative morbidity, highlighting the benefits of a complex approach to prevent the adverse events of post-operative IR and stress-induced hyperglycaemia.
About the Authors
Irina Aleksandrovna TarasovaRussian Research Surgery Center
Russian Federation
MD, PhD student of the Surgical Department I (Esophageal and Gastric surgery)
Competing Interests:
No conflict of interests
Alexey Leonidovich Shestakov
Russian Research Surgery Center
Russian Federation
MD, Head of the Surgical Department I (Esophageal and Gastric Surgery)
Competing Interests:
No conflict of interests
Vladimir Vladimirovich Nikoda
Russian Research Surgery Center
Russian Federation
MD, Head of Intensive Care Unit I
Competing Interests:
No conflict of interests
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1. Рисунок 1. Схема развития послеоперационной инсулинорезистентности и гипергликемии | |
| Subject | Инсулинорезистентность; хирургический стресс; стрессовая гипергликемия | |
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2. Рис. 1. Схема развития послеоперационной инсулинорезистентности и гипергликемии. | |
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| Type | Исследовательские инструменты | |
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Tarasova I.A., Shestakov A.L., Nikoda V.V. Post-operative insulin resistance. Diabetes mellitus. 2017;20(2):119-125. (In Russ.) https://doi.org/10.14341/7637
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