In this issue, the study by Lindseth (see page 741) of postoperative glucose metabolism in diabetic and nondiabetic patients not only points to some of the complex metabolic changes following trauma, but also illustrates some of the hazards in attempting definitive studies of glucose homeostasis when there is an intercurrent surgical procedure.
In addition to the deterioration of glucose tolerance seen after surgery (which in terms of the data presented by Lindseth could lead to a false diagnosis of mild diabetes in a nondiabetic subject, or perhaps missing mild glucose intolerance in a true mild diabetic subject), there are many other situations both in hospital and in office practice that could cloud the interpretation of the oral glucose tolerance test, the major test jor the diagnosis of early diabetes.1,2
Stress of any type appears to reduce glucose tolerance. In addition to surgery, conditions or situations such as pregnancy, infection,
Soeldner JS. Glucose Metabolism After Operation. Arch Surg. 1972;105(5):683. doi:10.1001/archsurg.1972.04180110008003