scholarly journals Early Postoperative Fasting Serum Glucose Levels are Useful in Depicting Future Diabetes Mellitus in Patients with Curative Insulinoma Surgery

2019 ◽  
Vol 128 (03) ◽  
pp. 158-163
Author(s):  
Aycan Akca ◽  
Achim A. R. Starke ◽  
Anna Dobek ◽  
Alexis Ulrich ◽  
Peter E. Goretzki

Abstract Background Hyperglycemia has been reported in some patients after curative insulinoma resection but no systematic investigation of glucose metabolism has been shown in a larger cohort of these patients. Therefore, it is still unknown, whether long lasting hyperinsulinism in insulinoma patients induces insulin resistance, which may jeopardize the postoperative health status of these patients. Methods Early postoperative fasting serum glucose levels were measured in all insulinoma patients after curative tumor resection during the first 48 h, being operated between 2011 and 2018, retrospectively. Results Of 77 (100%) patients with benign, spontaneous occuring insulinoma 51 (66.2%) patients were operated on by tumor enucleation. In 15 (19.5%) patients a left pancreatic resection was performed and in 11 (14.3%) patients the pancreatic head or the middle console of pancreatic corpus were excised. In 32 (41.6%) cases the highest fasting postoperative glucose levels were measured between 140–200 mg/dl. In 16 (20.8%) patients the glucose serum levels reached values above 200 mg/dl and in 4 (5.2%) patients short term substitution with insulin was indicated. Only one (1.3%) of these patients developed diabetes mellitus with the need of ongoing insulin treatment. Major postoperative complications were registered in 31 of all 77 patients (40.3%) and in 9 of 16 patients (56.3%) with postoperative glucose levels above 200 mg/dl. This difference was not statistically significant. Conclusions Early postoperative (first 48 h) fasting serum glucose levels in insulinoma patients showed significant hyperglycemia above 200 mg/dl in only few patients (20.8%) and chronic postoperative Diabetes mellitus developed in only one of 77 patients (<2%). Therefore, recovery of glucose metabolism after insulinoma resection is fast and medical intervention is not mandatory in most of these patients.

2007 ◽  
Vol 92 (12) ◽  
pp. 4893-4896 ◽  
Author(s):  
Guowen Cai ◽  
Shelley A. Cole ◽  
Nancy F. Butte ◽  
V. Saroja Voruganti ◽  
Anthony G. Comuzzie

Abstract Objective: The prevalence of childhood obesity has increased dramatically in the United States. Early presentation of type 2 diabetes has been observed in children and adolescents, especially in the Hispanic population. The genetic contribution of glucose homeostasis related to childhood obesity is poorly understood. The objective of this study was to localize quantitative trait loci influencing fasting serum glucose levels in Hispanic children participating in the Viva La Familia Study. Design: Subjects were 1030 children ascertained through an overweight child from 319 Hispanic families. Fasting serum glucose levels were measured enzymatically, and genetic linkage analyses were conducted using SOLAR software. Results: Fasting glucose was heritable, with a heritability of 0.62 ± 0.08 (P &lt; 0.01). Genome-wide scan mapped fasting serum glucose to markers D13S158–D13S173 on chromosome 13q (LOD score of 4.6). A strong positional candidate gene is insulin receptor substrate 2, regulator of glucose homeostasis and a candidate gene for obesity. This region was reported previously to be linked to obesity- and diabetes-related phenotypes. Conclusions: A quantitative trait locus on chromosome 13q contributes to the variation in fasting serum glucose levels in Hispanic children at high risk for obesity.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Eri Eguchi ◽  
Kazumasa Yamagishi ◽  
Ai Ikeda ◽  
Choy-Lye Chei ◽  
Hiroyuki Noda ◽  
...  

Introduction: The evidence for the relation between diabetes mellitus and risk of dementia in Asian population has been limited. This study investigated the association between diabetes mellitus and risk of dementia in community-based samples of Japanese. Hypothesis: There is an association between diabetes mellitus and risk of disabling dementia Methods: We performed a nested case-control study based on a cohort of about 6,000 Japanese aged 45-69 at baseline between 1984 and 1994. The information of the status of diabetes at baseline was collected for 174 disabling dementia cases incident between 1999 and 2004 and 348 controls matched with cases by age±3, sex and baseline-year. Incident disabling dementia was defined as dependent individuals who had moderate to severe dementia-related behavioral disturbance or cognitive impairment. This criterion was previously validated with 5-cog test. Dementia cases were further classified according to presence of history of stroke. The conditional odds ratio (OR) for dementia was calculated according to the status of (1) glucose intolerance; fasting serum glucose 110-125mg/dl or non-fasting serum glucose 140-199 mg/dl; and (2) diabetes; fasting serum glucose ≥126 mg/dl, non-fasting serum glucose ≥200 mg/dl, and/or the use of glucose-lowering medication or insulin therapy. Variables for multivariable adjustment were body mass index, smoking status, total cholesterol and hypertension status (140≤SBP<160 mmHg, 90≤DBP<95 mmHg for hypertension of grade 1, SBP ≥160 mmHg, DBP ≥95mmHg for hypertension of grade 2 and 3, and the treatment with an antihypertensive drug). Sex-specific analysis was also conducted as subanalysis. Results and Conclusions: Mean follow-up year was 11.4 years. The proportion of men was 32.8% and the prevalence of glucose intolerance and diabetes among controls were 16.7% and 5.8%, respectively. Of dementia cases, 44.8% had history of stroke. Compared with persons with normal glucose level, ORs (95%CI) for glucose intolerance and diabetes were 1.12 (0.68-1.84) and 2.18 (1.13-4.22), and multivariable ORs were 0.98 (0.58-1.65) and 2.04 (1.03-4.03), respectively. For sex stratified analysis, ORs for diabetes were 1.39 (0.45-4.31) for men, and 2.79 (1.20-6.50) for women. The association of diabetes was primarily observed in dementia cases with stroke history [OR=3.19 (1.04-9.82)], but not in those without it [OR=1.78 (0.78-4.07)]. In conclusion, we found an association between diabetes mellitus and risk of disabling dementia. The association was confined to women, and dementia with stroke history.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Song Vogue Ahn ◽  
Hyeon Chang Kim ◽  
Chung Mo Nam ◽  
Hyun Chul Lee ◽  
Il Suh

Objective: Diabetic women have a greater relative risk of coronary heart disease than diabetic men. However, gender difference in the impact of blood glucose levels below diabetic range on risk of coronary heart disease is unclear. The aim of this study is to evaluate whether the association between nondiabetic blood glucose levels and the incident risk of coronary heart disease is different in men and women. Methods: We measured fasting serum glucose levels and other cardiovascular risk factors in 172,580 Koreans (108,461 men and 64,119 women), aged 35–59 years in 1990 and 1992. Our primary outcomes were hospital admissions and deaths from coronary heart disease in 11 year follow-up from 1993 to 2003. Cox proportional hazard models were used to estimate the hazard ratios for coronary heart disease according to the baseline fasting serum glucose levels, after adjustment for age, body mass index, blood pressure, total cholesterol level, and cigarette smoking. Results: During the 11 years, 3,769 coronary heart disease events occurred. Risk of coronary heart disease in men was significantly increased at fasting serum glucose levels of diabetic range (≥ 126 mg/dL), although risk of coronary heart disease in women was significantly increased from impaired fasting glucose levels ≥ 110 mg/dL. In fasting serum glucose levels ≥ 110 mg/dL, the hazard ratios for coronary heart disease incidence were higher in women than in men compared with women and men with fasting glucose levels <80mg/dL, respectively. There was no association between impaired fasting glucose from 100 to 109 mg/dL and risk of coronary heart disease neither in men nor in women. Conclusions: The stronger impact of fasting serum glucose levels on relative risk of coronary heart disease in women compared with in men was significant from impaired fasting glucose levels ≥ 110 mg/dL. Adjusted Hazard Ratios (HRs) for Coronary Heart Disease by Fasting Serum Glucose Levels


Author(s):  
Ammar M.S. Almomin ◽  
Samih A. Odhaib ◽  
Mahmood T. Altemimi ◽  
Hussein A. Nwayyir ◽  
Ibrahim H. Hussein ◽  
...  

Objectives: This study was done to evaluate whether a shorter fasting duration of five to six hours can be used as an alternative to the usually recommended eight hours fasting serum glucose measurement. Methods: An observational, cross-sectional study was conducted during Ramadan (May) 2019, on 200 individuals. Two fasting serum glucose (FSG) venous samples taken, the first after 5-6 hours after predawn meal (suhoor), and the second after 8 hours. Participants were divided into two groups; normal individuals, and those who have type 2 diabetes mellitus (T2DM). Patients with T2DM further subdivided into three groups: those without treatment, those on oral antidiabetic drugs (OAD), and those using insulin and OAD. Results: There was no significant difference between the mean FSG readings in mg/dL (mmol/L) between the first and second samples for healthy individuals, 104.5 ± 21.4 (5.79±1.18) and 104.8 ± 12.6 (5.82±0.7), respectively. Generally, the same is true for T2DM patients with FSG values of 235 ± 107 (13.04±5.94) and 230 ± 105 (12.77±5.83). Untreated T2DM patients have consecutive FSG readings of 194.0 ± 151.5 (10.77±8.41) and 193.9 ± 128.9 (10.76±7.15), respectively, in the two samples without significant difference. Patients using insulin and OAD showed similar pattern of FSG 268 ± 111 (14.87±6.16) and 269 ± 114 (14.93±6.33), respectively. The only significant difference was observed in patients on OAD which have 220 ± 78 (12.21±4.33) and 207 ± 77 (11.49±4.27) for their successive FSG samples. Conclusions: The overnight fasting duration of 5-6 hours, can give a comparable measurement of fasting serum glucose as that obtained by 8 hours. Keywords: Glucose; Fasting; Duration; Diabetes Mellitus


2003 ◽  
Vol 24 (10) ◽  
pp. 776-778 ◽  
Author(s):  
Stephen J. Wilson ◽  
Daniel J. Sexton

AbstractWe conducted a case-control study to investigate the relationship between preoperative fasting serum glucose and postoperative mediastinitis in patients undergoing open heart surgery. Multivariate analysis revealed that a glucose level of 126 mg/dL or greater was associated with a significantly increased risk of mediastinitis (OR, 5.25; P = .002).


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