Effect of intensive insulin therapy on the clinical results of postoperative patients with gastric cancer / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the influence of intensive insulin therapy on the results of postoperative patients with gastric cancer.</p><p><b>METHODS</b>Forty-six patients with gastric cancer underwent radical operation were randomly divided into two groups intensive group (n=23, to control blood glucose at 4.4 to 6.1 mmol/L) and conventional group (n=23, to control blood glucose at 10.0 to 11.1 mmol/L). Fasting blood glucose( FBG), fasting insulin (FINS), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and C reaction protein (CRP) in 46 patients were detected dynamically during perioperative period. Insulin resistance index (HOMA-IR) were calculated using Homeostasis Model Assessment (HOMA) to evaluate insulin sensitivity. Postoperative complications and other clinical data were recorded.</p><p><b>RESULTS</b>No hypoglycemia occurred in the two groups. Compared with conventional group, morbidity and postoperative duration of fever, antibiotic use and the length of hospital stay in intensive group were significantly reduced (P < 0.05). On the day 1 and 3 after surgery, HOMA-IR and serum levels of TNF-alpha, IL-6 and CRP in patients of intensive group were significantly lower than those in conventional group (P < 0.05).</p><p><b>CONCLUSIONS</b>Intensive insulin therapy could counteract the state of high-inflammation and then improve the outcome of postoperative patients.</p>