Post-operative insulin resistance
Post-operative insulin resistance (IR) is a recognised marker of surgical stress. However, the reasons underlying post-operative IR and its clinical value are still unclear. IR has been described as a pathological condition, in which organs and tissues fail to respond to the hormone insulin, resulti...
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| Autores principales: | , , |
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| Formato: | article |
| Lenguaje: | EN RU |
| Publicado: |
Endocrinology Research Centre
2017
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/bcf4543161f14799a513dbd42c1c9651 |
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| Sumario: | Post-operative insulin resistance (IR) is a recognised marker of surgical stress. However, the reasons underlying post-operative IR and its clinical value are still unclear. IR has been described as a pathological condition, in which organs and tissues fail to respond to the hormone insulin, resulting in acute hyperglycaemia. Post-operative IR in patients without type 2 diabetes has been identified as an independent, negative predictor of post-operative outcome. Studies have shown a direct relationship between post-operative morbidity (including complications from infection) and total mortality in patients with acute hyperglycaemia compared with diabetic patients. IR and stress-induced hyperglycaemia in the early post-operative period may be corrected by insulin infusion; however, this has often been associated with hypoglycaemia. Detection and modification of risk factors in the pre- and intra-operative periods may decrease the frequency of IR and hyperglycaemia and eliminate the use of insulin. In this literature review, the mechanisms underlying the development and prevention of post-operative IR, and its clinical value are discussed. This study demonstrates the relationship between IR and post-operative morbidity, highlighting the benefits of a complex approach to prevent the adverse events of post-operative IR and stress-induced hyperglycaemia. |
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