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Post-operative insulin resistance

https://doi.org/10.14341/7637

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 Tarasova

Russian 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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Supplementary files

1. Рисунок 1. Схема развития послеоперационной инсулинорезистентности и гипергликемии
Subject Инсулинорезистентность; хирургический стресс; стрессовая гипергликемия
Type рисунок
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2. Рис. 1. Схема развития послеоперационной инсулинорезистентности и гипергликемии.
Subject
Type Исследовательские инструменты
View (195KB)    
Indexing metadata ▾

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For citations:


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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