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Article
November 1972

Postoperative Glucose Metabolism in Diabetic and Nondiabetic PatientsThe Response of Glucose, Insulin, Growth Hormone, Corticosteroids, Epinephrine, and Unesterified Fatty Acids to Extremity Surgery

Author Affiliations

Indianapolis
From the Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis.

Arch Surg. 1972;105(5):741-745. doi:10.1001/archsurg.1972.04180110064016
Abstract

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.

References
1.
Thompson V:  Studies of trauma and carbohydrate metabolism with special references to the existence of traumatic diabetes . Acta Med Scand ( (suppl 91) ):1-416, 1938.
2.
Pekkarinen A:  On the adrenocortical reserve and the excretion of 17-hydroxycorticosteroids, 17-ketosteroid, noradrenalin, and adrenaline in middle-aged and elderly patients after surgical operations . Acta Physiol Scand 42( (suppl 145) ):113, 1957.
3.
Ross H, Johnston IDA, Welborn TA, et al:  Effect of abdominal operations on glucose tolerance and serum levels of insulin, growth hormone, and hydrocortisone . Lancet 2:563-566, 1966.Article
4.
Allison SP, Hinton P, Chamberlain MS:  Intravenous glucose tolerance, insulin, and free fatty acid levels in burned patients . Lancet 1:113-115, 1968.
5.
Mosenthal HO, Barry E:  Criteria for and interpretation of normal glucose tolerance tests . Ann Intern Med 33:1175-1194, 1950.Article
6.
Morgan CR, Lazarow A:  Immunoassay of insulin using a two-antibody system . Proc Soc Exp Biol 110:24-32, 1962.Article
7.
Hoffman WS:  A rapid photoelectric method for the determination of glucose in blood and urine . J Biol Chem 120:51-60, 1937.
8.
Davis BD:  The estimation of small amounts of fatty acid in the presence of polyoxethylene sorbitan partial fatty acid esters and serum proteins . Arch Biochem 15:351, 1947.
9.
Eichhorn F, Rutenberg A:  Low voltage paper electrophoretic method for determination of urinary V.M.A . Clin Chem 9:615, 1963.
10.
Hadd H, Perloff WH: An improved method for the determination of 17-hydroxycorticosteroids in serum and urine. Read before the 126th meeting of the American Chemical Society, Division of Biological Chemistry, 1951.
11.
Goodman MH:  Effects of growth hormone on glucose utilization in diaphragm muscle in the absence of increased lipolysis . Endocrinology 81:1099-1103, 1967.Article
12.
Beck P, Parker ML, Doughaday WH:  Paradoxical hypersecretion of growth hormone in response to glucose . J Clin Endocrinol Metab 26:463-469, 1966.Article
13.
Orskov H, Christensen NJ:  Growth hormone in uremia . J Clin Lab Invest 27:51-60, 1971.Article
14.
Catt KJ:  Growth hormone . Lancet 1:937, 1970.
15.
Long CL, Spencer JL, Kinney JM, et al:  Carbohydrate metabolism in man: Effect of elective operations and major injury . J Appi Physiol 31:110-116, 1971.
16.
Seltzer HS, Allen EW, Herron AL Jr, et al:  Insulin secretion in response to glycemic stimulus: Relation of delayed initial release to carbohydrate intolerance in mild diabetes mellitus . J Clin Invest 46:323-335, 1967.Article
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