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Observational Study
. 2015 Jul 21;10(1):145-50.
doi: 10.1177/1932296815595985.

Perioperative Hyperglycemia and Glucose Variability in Gynecologic Laparotomies

Jorinde A W Polderman  1 , Markus W Hollmann  2 , J Hans DeVries  3 , Benedikt Preckel  2 , Jeroen Hermanides  4
Affiliations
Observational Study

Perioperative Hyperglycemia and Glucose Variability in Gynecologic Laparotomies

Jorinde A W Polderman et al. J Diabetes Sci Technol. .

Abstract

Background: The glycemic response and its relation to postoperative complications following gynecologic laparotomies is unknown, although these surgeries carry a substantial risk for postoperative morbidity. Therefore, our objective was to assess the prevalence of perioperative hyperglycemia and glucose variability in women undergoing a gynecologic laparotomy.

Methods: In this prospective cohort study, capillary glucose was measured every hour during the perioperative period. The primary outcome measures were the proportion of patients with postoperative hyperglycemia (glucose >180 mg d l(-1)) and the glucose variability in the intra- and postoperative period. Postoperative complications were assessed as secondary outcome measure.

Results: We included 150 women undergoing a gynecologic laparotomy. Perioperative hyperglycemia occurred in 33 patients without diabetes (23.4%) and in 8 patients with diabetes (89%). Glucose variability was significantly higher (mean absolute glucose change [MAG] 11 mg dl(-1) hr(-1) [IQR 8-18]) in the intraoperative compared to the postoperative period (MAG 10 mg dl(-1) hr(-1) [IQR 3-16], P = .03). Neither hyperglycemia nor glucose variability was associated with postoperative complications.

Conclusions: Hyperglycemia and glucose variability seem to be a minor problem during gynecologic laparotomy. Based on the current data, we would not advocate standardized glucose measurements in every patient without diabetes undergoing gynecologic laparotomy.

Keywords: glucose variability; hyperglycemia; perioperative period; postoperative complications.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Consort flow diagram for the PAVAS study.
Figure 2.
Figure 2.
Perioperative median glucose with IQR. n, number of patients; S0, preoperative; S1-S6, hours intraoperative; R0-R6, hours of postoperative recovery period; W1-W3, fasting glucose day 1-3 on the ward.
Figure 3.
Figure 3.
Intra- and postoperative glucose variability. Expressed as mean absolute glucose change per hour (MAG).
See this image and copyright information in PMC

References

    1. Chiantera V, Rossi M, De IP, et al. Morbidity after pelvic exenteration for gynecological malignancies: a retrospective multicentric study of 230 patients. Int J Gynecol Cancer. 2014;24:156-164. - PubMed
    1. Abdelmalak BB, Bonilla AM, Yang D, et al. The hyperglycemic response to major noncardiac surgery and the added effect of steroid administration in patients with and without diabetes. Anesth Analg. 2013;116:1116-1122. - PubMed
    1. Eshuis WJ, Hermanides J, van Dalen JW, et al. Early postoperative hyperglycemia is associated with postoperative complications after pancreatoduodenectomy. Ann Surg. 2011;253:739-744. - PubMed
    1. van den Berg TJ, Bogers H, Vriesendorp TM, et al. No apparent impact of increased post-operative blood glucose levels on clinical outcome in kidney transplant recipients. Clin Transplant. 2009;23:256-263. - PubMed
    1. Vriesendorp TM, Morelis QJ, DeVries JH, Legemate DA, Hoekstra JB. Early post-operative glucose levels are an independent risk factor for infection after peripheral vascular surgery. A retrospective study. Eur J Vasc Endovasc Surg. 2004;28:520-525. - PubMed

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