scholarly journals Glucose, C-peptide and Cortisol Response To Surgery Under General Anesthesia In Diabetic Subjects with Treatment Variability

2009 ◽  
Vol 20 (1) ◽  
pp. 3-8
Author(s):  
K Sardar ◽  
UHS Khatun ◽  
L Ali ◽  
NN Chowdhury ◽  
KM Iqbal
Keyword(s):  
Blood Glucose ◽  
General Anesthesia ◽  
Plasma Glucose ◽  
Plasma Glucose Level ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cortisol Response ◽  
C Peptide ◽  
Type 2 Diabetic

Diabetic patients are considered to be at increased risk of perioperative morbidity and mortality because of the involvement of their vital organs and the autonomic nervous system in the natural course of the disease. Various aspects of anesthesia and surgery cause stress induced hemodynamic, endocrine and metabolic changes in type 2 diabetic subjects. The present study was designed to investigate the surgical stress response difference between the patients groups those who are treated with only insulin and with insulin-oral hypoglycaemic drugs combination before surgery. Stress response was measured with the changes of blood glucose, C-peptide and cortisol. A total number of 30 subjects who were admitted in BIRDEM hospital in fit physical condition (ASA Class I & II) were selected for the present study. Among them 15 patients were treated with only insulin and 15 patients were treated with insulin- OHA combination before surgery. All of the subjects were received total abdominal hysterectomy under general anesthesia. Three samples were collected from each subject. The first sample (control, PT0) was collected just before anesthesia; second sample (PT1) collected 10 minutes after incision and third sample (PT2) collected 10 minutes after extubation. Plasma glucose was measured by glucose oxidase method, serum C-peptide and cortisol by chemiluminescent based ELISA technique. The mean±SD age and BMI were 44±6 years and 24.4±3.0 kg/m2 respectively. In insulin treated group, the plasma glucose level was significantly higher in PT2 and it was about 147% whereas in insulin-OHA group, the plasma glucose level was significantly higher in both PT1 (111%) and PT2 (196%). The serum C-peptide values were decreasing tendency but not significant in both groups. The serum cortisol level was increased gradually and significantly higher in PT2 in both groups. The data suggest that a) insulin treatment alone is more effective than insulin-OHA combination to control blood glucose in type 2 diabetic subjects undergoing surgery under general anesthesia, b) lower abdominal surgery under general anesthesia in well controlled type 2 diabetic subjects is accompanied by a hyperglycemic response which results from rise of insulin antagonists like cortisol rather than fall of insulin secretion, but the two treatment modalities lead to similar cortisol response. Key words: General anesthesia, Serum glucose, cortisol, Total abdominal hysterectomy Journal of BSA, Vol. 20, No. 1, January 2007 p.3-8

scholarly journals Body Mass Index, Fasting Plasma Glucose Levels, and C-peptide Levels as Predictors of the Future Insulin Use in Japanese Type 2 Diabetic Patients

2010 ◽  
Vol 57 (3) ◽  
pp. 237-244 ◽  
Author(s):  
Atsushi GOTO ◽  
Maki TAKAICHI ◽  
Miyako KISHIMOTO ◽  
Yoshihiko TAKAHASHI ◽  
Hiroshi KAJIO ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
C Peptide ◽  
Glucose Levels ◽  
Insulin Use ◽  
Type 2 Diabetic

scholarly journals Non-obese population with the rs7903146 T allele exhibits higher sugar and more dyslipidaemia in subjects with Type-2-diabetes

2020 ◽  
Author(s):  
Sarah Shaibu ◽  
Ishaya Yohanna Longdet ◽  
Carrol Domkat Luka ◽  
Jesse Fanen Ortswen ◽  
Gloria Eleojo Eneojoabah ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Sugar ◽  
Glucose Level ◽  
Plasma Glucose ◽  
Plasma Glucose Level ◽  
Density Lipoprotein ◽  
C Peptide ◽  
Postprandial Plasma Glucose ◽  
Obese Population

Type 2 diabetes (T2D), the most prevalent type of diabetes has been associated with Transcription-Factor-7-Like-2 gene Single Nucleotide Polymorphisms (SNPs), rs12255372 and rs7903146 as risk factors, thought to be modulated by obesity status. In sub-Saharan Africa, the onset of T2D in the non-obese is rarely suspected. This study looks into the genetics and the biochemical parameters in non-obese population, with and without T2D and living in Jos, Nigeria. A total of 68 subjects, 40 diabetic patients and 28 healthy control group, all with closely matched age, height, nutrition, family history, Body Mass Index and socioeconomic status, recruited from within the same population were studied. SNPs Genotyping were performed using Polymerase Chain Reaction and Sangers Sequencing. Lipid profiles, Fasting Blood Sugar and C-peptide levels were measured and analysed alongside with demographic data from questionnaire. Odd-ratio at 95% confidence interval at a conventional level of alpha, <0.05 and Product Moment Correlation Coefficient Analysis were used to analyse the data in both groups. The entire population showed the GG genotype for the rs12255372. However, different genotype combination, CC, CT and TT were observed with the rs7903146. Though no significant association was observed between the genotypes and the odd of T2D, healthy subjects with the T allele showed a higher level of two hours postprandial plasma glucose level than those with CC genotype. Patients with T allele shows a more abnormal level of diabetes metabolic syndrome indicators such as Fasting Blood Sugar; two hours postprandial plasma glucose level; C-peptide; Low Density Lipoprotein, High Density Lipoprotein and Total Cholesterol. The study suggests that lower sugar metabolism and more dyslipidaemia are observed in subject with T allele. Hence, this could constitute poorer prognosis and a risk factor for non-obese population, particularly with high carbohydrate intake.

Effects of ginger (Zingiber officinale) on plasma glucose level, HbA1c and insulin sensitivity in type 2 diabetic patients

2013 ◽  
Vol 64 (6) ◽  
pp. 682-686 ◽  
Author(s):  
Sepide Mahluji ◽  
Vahide Ebrahimzade Attari ◽  
Majid Mobasseri ◽  
Laleh Payahoo ◽  
Alireza Ostadrahimi ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Level ◽  
Plasma Glucose ◽  
Plasma Glucose Level ◽  
Zingiber Officinale ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

scholarly journals Small Intestinal Glucose Delivery Affects the Lowering of Blood Glucose by Acute Vildagliptin in Type 2 Diabetes

2016 ◽  
Vol 101 (12) ◽  
pp. 4769-4778 ◽  
Author(s):  
Tongzhi Wu ◽  
Xiang Zhang ◽  
Laurence G. Trahair ◽  
Michelle J. Bound ◽  
Tanya J. Little ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Emptying ◽  
Plasma Glucose ◽  
Glucose Infusion ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Glucose Lowering ◽  
C Peptide ◽  
Type 2 Diabetic

Context: The rate of gastric emptying is an important determinant of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) secretion and may influence the magnitude of glucose lowering by dipeptidyl peptidase-4 (DPP-4) inhibitors. Objective: To evaluate the effects of the DPP-4 inhibitor, vildagliptin (VILD), during intraduodenal (ID) glucose infusion at 2 different rates within the physiological range of gastric emptying, in type 2 diabetes. Participants and Design: A total of 16 diet-controlled type 2 diabetic patients were studied on 4 separate days in double-blind, randomized, fashion. On each day, either 5-mg VILD or placebo (PLBO) was given 60 minutes before a 120-minute ID glucose infusion at 2 or 4 kcal/min (ID2 or ID4). Plasma glucose and hormones were measured frequently. Results: Plasma glucose, insulin, C-peptide, glucagon, total GIP, and total and intact GLP-1 concentrations were higher during ID4 than ID2 (P &lt; .01 for each). Compared with PLBO, VILD was associated with higher intact GLP-1, insulin, and C-peptide and lower glucose and total GIP and GLP-1 (P &lt; .01 for each), without affecting glucagon. There were significant interactions between the rate of ID glucose and VILD treatment on plasma glucose, intact and total GLP-1, and GIP (P &lt; .05 for each) but not insulin, C-peptide, or glucagon. The reduction in glucose and the increment in intact GLP-1 after VILD vs PLBO were 3.3- and 3.8-fold greater, respectively, during ID4 compared with ID2. Conclusions/Interpretation: These observations warrant further study to clarify whether type 2 diabetic patients with relatively more rapid gastric emptying have greater glucose lowering during treatment with DPP-4 inhibitors.

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