Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Having heart surgery? Watch your blood sugar, especially if you're overweight or older

10.06.2008
People with no history of diabetes may have sustained high glucose levels even after surgery, and need treatment

Nearly half of all heart surgery patients may experience blood sugar levels high enough to require temporary insulin treatment after their operation, even though they've never had diabetes, according to a new study from the University of Michigan Health System.

And a significant minority of those patients might need to take medicines for days or even weeks after they leave the hospital, to help their blood sugar levels reach normal again, the researchers show. Obese patients, older patients, and those whose blood sugar levels were still high two days after their operation are most likely to need this kind of treatment, they find.

Although the study didn't look at whether such patients later developed true diabetes or pre-diabetes, the results are striking enough to warrant a new U-M research project. It will recruit patients before their operations, and will include longer follow-up and more rigorous testing of pre-surgery and post-hospitalization blood sugar levels.

On Sunday at the American Diabetes Association's Scientific Sessions in San Francisco, a U-M team presented their findings in a poster that included retrospective data from 1,362 patients who had certain heart and vascular operations at U-M in 2006 and 2007.

Of them, 662 developed "stress induced hyperglycemia", or high blood sugar after surgery, and 87 needed blood sugar medicines when they left the hospital.

The study was possible because UMHS has a dedicated team of physicians, physician assistants and nurse practitioners called the Hospital Intensive Insulin Program who look for and treat elevated blood sugar in all heart and vascular surgery patients. Led by U-M endocrinologist Roma Gianchandani, M.D., the team gives insulin and oral medicines during these patients' hospital stays, and prescribes medicines for the patients to take at home. They also recommend that such patients receive further blood-sugar testing from their primary care doctors.

But high blood sugar in non-diabetic patients after surgery hasn't been fully studied, says Sima Saberi, M.D., the U-M endocrinology fellow who presented at the ADA meeting.

Stress-induced hyperglycemia occurs when the body reacts to the double insults of having an operation on the heart or major blood vessels, and of being cooled down by the heart-bypass machine to protect the heart muscle during surgery.

Heart and vascular surgeons already know that high blood sugar during surgery itself is associated with worse recovery and a higher risk of infection and death. So, most heart and blood vessel surgery patients currently have their blood sugars monitored while they're in the operating room, and many patients receive doses of insulin while the operation is going on.

The new study looked at what happened after surgery, and what factors predicted a need for blood sugar treatment. By far, the most telling sign that a person was likely to need such treatment -- both in the hospital and as they went home -- was their average blood sugar two days after surgery.

Those patients whose glucose levels were still high at this point were more than two and a half times more likely to need post-hospital medicines, even after other factors were considered.

Patients who had a body mass index (BMI) over 35, which is consistent with a diagnosis of obesity, were also somewhat more likely to develop SIH, as were older patients. But these factors were not nearly as strongly predictive of SIH as was the glucose level on the second day after surgery.

Still, Saberi says, overweight patients who carry their excess weight mainly around their waists, in the form of belly fat, are more likely to have metabolic syndrome, which involves both increased cardiovascular risk and increased risk of diabetes.

The patients in the study had either a coronary artery bypass operation, a heart valve operation, or an operation on the upper part of their aorta, the major blood vessel that leads out of the heart to the rest of the body.

Kara Gavin | EurekAlert!
Further information:
http://www.umich.edu
http://www.med.umich.edu/intmed/endocrinology/staff/HIIP.htm

More articles from Health and Medicine:

nachricht Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin

nachricht Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

Im Focus: Using graphene to create quantum bits

In the race to produce a quantum computer, a number of projects are seeking a way to create quantum bits -- or qubits -- that are stable, meaning they are not much affected by changes in their environment. This normally needs highly nonlinear non-dissipative elements capable of functioning at very low temperatures.

In pursuit of this goal, researchers at EPFL's Laboratory of Photonics and Quantum Measurements LPQM (STI/SB), have investigated a nonlinear graphene-based...

Im Focus: Bacteria harness the lotus effect to protect themselves

Biofilms: Researchers find the causes of water-repelling properties

Dental plaque and the viscous brown slime in drainpipes are two familiar examples of bacterial biofilms. Removing such bacterial depositions from surfaces is...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

Innovation 4.0: Shaping a humane fourth industrial revolution

17.05.2017 | Event News

 
Latest News

Scientists propose synestia, a new type of planetary object

23.05.2017 | Physics and Astronomy

Zap! Graphene is bad news for bacteria

23.05.2017 | Life Sciences

Medical gamma-ray camera is now palm-sized

23.05.2017 | Medical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>