ABSTRACT
Objective To evaluate the post-operative glucose level and insulin dose of patients undergoing total pancreatectomy.Methods From September 1980 to September 2014, 21 patients underwent total pancrea-tectomy in Peking Union Medical College Hospital, who were enrolled in our study.We reviewed the changes in their insulin dosage and glucose levels after operation, also summarized type and dose of insulin as well as glucose level in stable period.Results The required insulin dose reached peak within 4 days after surgery ( maximum dose 300 U/d).The average dose was (143.5 ±62.8) U/d and decreased gradually.During the perioperative period (needing parenteral nutrition), the blood glucose level fluctuated markedly (1.52-29.06 mmol/L) and the average level was (11.18 ±0.95) mmol/L.During the stable period ( without parenteral nutrition) , patients on average had (5.3 ±2.0) U of preprandial rapid-acting insulin and (8.1 ±2.9) U of long-acting insulin be-fore sleeping;the average fasting blood glucose was (6.69 ±1.48) mmol/L, 2 h postprandial blood glucose was (9.08 ±2.84) mmol/L, bedtime blood glucose was (9.66 ±2.49) mmol/L, and blood glucose level at night was (8.15 ±2.78) mmol/L.67%of the patients had 13 hypoglycemic episodes monthly on average.For those five followed-up patients, the average hemoglobin A1c was (6.15 ±1.20)%.Conclusions Patients undergoing total pancreatectomy may experience marked fluctuation of blood glucose level and short-term increase of insulin need which gradually decreases afterwards.After entering the stable period, the glucose level could be well-con-trolled but with frequent hypoglycemia.There is no diabetic ketoacidosis.
ABSTRACT
The Dextrostix/Reflectance Meter (GLUCOSCOT GT-4310) for measuring blood glucose con centration was studied. We compared 75 blood glucose values measured by GLUCOSCOT with serum glucose values by laboratory glucose oxidase method. And their correlations were excellent (r=0.96961). This study proved that this portable monitor is valuable in providing anesthesiologists with a rapid and precise method for monitoring blood glucose concentrations in operating room. Perioperative blood glucose concentrations were measured by GLUCOSCOT in gynecologic patients anesthetized with Thalamonal (group 1), halothane (group 2) or enflurane (group 3). Blood glucose values increased significantly after intubation and more increased after start of surgery with time, but these changes were not significant clinically (<120 mg/dl). Changes of blood glucose, mean blood pressure and pulse rate were not different statistically from each other groups.