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Related Experiment Videos

Insulin resistance after abdominal surgery

A Thorell1, S Efendic, M Gutniak

  • 1Department of Surgery, Karolinska Hospital and Institute, Stockholm, Sweden.

The British Journal of Surgery
|January 1, 1994
PubMed
Summary

Postoperative insulin resistance significantly impacts patients after abdominal surgery, peaking on day one and lasting at least five days. Insulin sensitivity gradually recovers over 20 days, indicating a prolonged metabolic disruption following surgery.

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Area of Science:

  • Metabolic Surgery
  • Endocrinology
  • Physiology

Background:

  • Postoperative insulin resistance is a common complication following major surgery.
  • Understanding its time course and contributing factors is crucial for patient management.

Purpose of the Study:

  • To investigate the temporal pattern and magnitude of insulin resistance after elective abdominal surgery.
  • To identify potential hormonal regulators of postoperative insulin resistance.

Main Methods:

  • Utilized the hyperinsulinaemic-normoglycaemic glucose clamp technique to measure insulin sensitivity.
  • Assessed insulin sensitivity in patients before and on days 1, 5, 9, and 20 after open cholecystectomy.
  • Monitored plasma levels of glucose, insulin, C-peptide, and other hormones.

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Main Results:

  • Insulin sensitivity significantly reduced by 54% on the first postoperative day.
  • Marked insulin resistance persisted for at least 5 days.
  • Insulin sensitivity returned to baseline levels by postoperative day 20.
  • Elevated postoperative glucose, C-peptide, noradrenaline, and glucagon were observed, while insulin, growth hormone, cortisol, and adrenaline remained unchanged.

Conclusions:

  • Elective upper abdominal surgery induces significant and persistent insulin resistance.
  • Hormonal changes alone do not fully explain the observed postoperative insulin resistance.
  • Further research is needed to elucidate the mechanisms underlying sustained insulin resistance post-surgery.