A study of postoperative glucose metabolism in eight diabetic and 23 nondiabetic patients undergoing operations on the lower extremity showed the following changes: elevated fasting levels of glucose and unesterified fatty acids, most marked two days after surgery; one hour after dextrose ingestion the blood glucose level in diabetics was below preoperative levels while in the nondiabetics it was elevated. Both diabetics and nondiabetics showed a delayed fall of the blood glucose to fasting levels. Postoperative insulin concentrations were elevated in nondiabetic and suppressed in diabetic patients. Both 17-hydroxycorticosteroid and growth hormone levels were elevated in the postoperative period. It is possible that they influenced the observed changes in glucose metabolism.
Lindseth RE. Postoperative Glucose Metabolism in Diabetic and Nondiabetic PatientsThe Response of Glucose, Insulin, Growth Hormone, Corticosteroids, Epinephrine, and Unesterified Fatty Acids to Extremity Surgery. Arch Surg. 1972;105(5):741-745. doi:10.1001/archsurg.1972.04180110064016