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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.
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
October 2013,
Journal of perioperative practice,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
April 1995,
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
November 1977,
The Journal of clinical endocrinology and metabolism,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
October 2017,
Parasites & vectors,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
June 1994,
Infusionstherapie und Transfusionsmedizin,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
January 1984,
Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
September 1978,
Metabolism: clinical and experimental,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
December 1996,
Clinical endocrinology,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
August 1990,
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed,
J O Nygren, and
A Thorell, and
M Soop, and
S Efendic, and
K Brismar, and
F Karpe, and
K S Nair, and
O Ljungqvist
January 1989,
Scandinavian journal of thoracic and cardiovascular surgery,
