Related Experiment Video
Updated: May 25, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Blood glucose control in the perioperative period
1Department of Anesthesiology, Gunma University Hospital, Japan. kadoi@med.gunma-u.ac.jp
Abstract:
Extensive data have shown that acute hyperglycemia is commonly present in the perioperative period among patients undergoing surgery or with critical illness, and a direct relationship between perioperative hyperglycemia and mortality has been established. An outstanding trial by Van den Berghe showed that intensive insulin therapy (IIT) (target blood glucose, 80-110 mg/dL) reduced in-hospital mortality. However, recent large trials have questioned the efficacy and safety of IIT and raised concerns about increased mortality rates due to hypoglycemia. This review focused on how anesthetic agents and techniques, fluid management and preoperative oral intake would affect glucose metabolism and insulin resistance, in addition to recent controversial effects of IIT on improved mortality rate. Anesthesiologists should pay attention not only to the efficacy and risks of IIT during the perioperative period, but also to effects of fluid management, anesthetic agents and techniques during anesthesia on glucose homeostasis.
Related Concept Videos
Hypoglycemia and Glucagon
Hyperglycemia
Hormones Regulating Blood Glucose
In addition to accelerating glucose uptake and utilization, insulin has...
Glucose Homeostasis: Regulation of Blood Glucose
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
Diabetes Mellitus: Type 2 and Gestational
Hypoglycemia
