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- Title
Preceding Diabetes Mellitus: No Impact on The Changes of Blood Glucose Level During Whipple Surgery.
- Authors
Gokdere, Semiha Cagatay; Pamuk, Almıla Gülsün; Üzümcügil, Filiz
- Abstract
Background: Whipple surgery with manipulation and resection of pancreas causes blood glucose changes, some of which develop into Type 3 DM. Our aim was to determine the difference, if any, between blood glucose changes that develop in patients with and without preceding DM while still in surgery. Materials and Methods: We retrospectively studied files of 86 patients (> 18 years, ASA I-III) who had Whipple surgery between Jan 1st -Mar 1st 2021. All patients had at least 4 blood glucose levels measured and recorded (start of operation, during pancreatic manipulation and resection, end of surgery). There were 32 patients with preceding diagnosis of DM and 54 without. Any surges or dips in blood glucose and relating interventions were studied. Results and Discussion: All patients with preceding DM were coded as Type 2, onset times and relation to pancreatic disease was unavailable. Regardless of DM, blood glucose measurement at the beginning of the operation (1st measurement) was significantly lower than the 2nd, 3rd, and 4th measurements in all patients; there was no difference between the 2nd and 3rd measurements, and the 4th measurement was significantly higher. Blood glucose changes during the operation were much steeper in patients without DM (P=0.012), The effect of DM diagnosis alone on blood glucose measurement values was not found significant (p=0.139), but diabetic patients were treated more promptly with Insulin if over a Glucose threshold of >=180 mg/dl (p=0.01). Previous studies showed a correlation with 'early' postoperative blood glucose changes and onset of new Type 3b DM, but intraoperative surges were never studied or correlated. Conclusions: The observed intraoperative blood glucose increase was steep and significant. This finding should be confirmed by prospective studies and investigated as a likely early indicator for the subsequent development of Type 3c DM.
- Subjects
BLOOD sugar; DIABETES; BLOOD sugar measurement; BLOOD sugar monitors; PANCREATIC diseases; PANCREATIC surgery
- Publication
Journal of Anesthesia / Anestezi Dergisi (JARSS), 2023, Vol 31, p230
- ISSN
1300-0578
- Publication type
Article