C-reactive protein dictates postoperative insulin requirements
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Adults with type 2 diabetes who undergo surgery need more insulin following surgery, particularly if they experience increased C-reactive protein level or HbA1c, according to findings published in the Journal of Diabetes Investigation.
“We found an association between postoperative C-reactive protein levels and the doses of insulin administered,” Yuya Tsurutani, MD, PhD, of the department of endocrinology and diabetes at Yokohama Rosai Hospital in Yokohama, Japan, and colleagues wrote. “The findings led us to speculate that C-reactive protein levels could be a metric for determining insulin requirements.”
Tsurutani and colleagues assessed levels of C-reactive protein, HbA1c and estimated glomerular filtration rate, as well as insulin requirements before and after surgery, among 49 adults with type 2 diabetes (mean age, 74.04 years; 47% women) who had lumbar spinal canal stenosis surgery.
“Patients with lumbar spinal canal stenosis were selected owing to the low postoperative infection risk, high post-surgery C-reactive protein levels and restricted physical activity, which impairs glucose tolerance,” the researchers wrote.
Insulin requirements rose by a mean of 3.11 U per day (95% CI, 1.14-5.07) after surgery for participants. There was a mean 0.6 U per day rise in insulin requirements for every 1 mg/dL increase in C-reactive protein (95% CI, 0.33-0.86), and when a 1% rise in HbA1c was also present, there was a mean 0.91 U per day rise in insulin requirements (95% CI, 0.52-1.3).
“The degree of association between C-reactive protein levels and insulin resistance was higher in patients with higher HbA1c levels,” the researchers wrote. “The present findings probably indicate the synergistic effects of postoperative inflammation and preoperative glycemic control on insulin resistance.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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