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J Diabetes Sci Technol · Jul 2015
Observational StudyPerioperative Hyperglycemia and Glucose Variability in Gynecologic Laparotomies.
- Jorinde A W Polderman, Markus W Hollmann, J Hans DeVries, Benedikt Preckel, and Jeroen Hermanides.
- Department of Anaesthesiology, Academic Medical Centre, Amsterdam, Netherlands j.a.polderman@amc.uva.nl.
- J Diabetes Sci Technol. 2015 Jul 21; 10 (1): 145-50.
BackgroundThe 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.MethodsIn 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.ResultsWe 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.ConclusionsHyperglycemia 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.© 2015 Diabetes Technology Society.
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