The British journal of surgery
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Uncontrolled diabetes severely impairs early healing of experimental intestinal anastomosis. This study aimed to compare the potential beneficial effect of insulin treatment, started before or immediately after surgery. A normal blood glucose level was attained in diabetic rats by twice-daily administration of insulin, commenced either 4 days before operation (insulin-1 group) or on the day of operation (insulin-2 group). ⋯ After 7 days mean bursting pressures in both ileum and colon were restored to control levels in the insulin-1 group but not in the insulin-2 group. Anastomotic abscess formation after 3 days was also significantly (P < 0.017) more common in the diabetic and insulin-2 groups, but not in the insulin-1 group than in the control group. Postoperative blood glucose control alone does not completely prevent the detrimental effects of uncontrolled diabetes on healing intestinal anastomoses.