Insulin Resistance, Glycemia and Cortisol Levels in Surgical Patients who Had Preoperative Caloric Load with Amino Acids

Abstract

Pre-operative caloric load (amino acids) reduces the level of insulin resistance and glucose in the presence of elevated cortisol levels.

Effect of an intraoperative infusion of amino acids on body temperature, serum biochemistry, serum insulin and recovery variables in healthy dogs undergoing ovariohysterectomy

“…29 Of interest, AA infusion has been shown to improve β cell and insulin function in the face of increased cortisol associated with the stress of surgery. 30 This may indicate that AAs have a protective efect against surgical stresses that cause insulin resistance in postsurgical human patients. 31 The impact of AA infusion on the efects of surgical stresses has not been studied in small animals.…”

“…Additionally, AAs supplied to the liver act a substrate for gluconeogenesis and result in elevated serum glucose which is transported to tissues throughout the body 29 . Of interest, AA infusion has been shown to improve β cell and insulin function in the face of increased cortisol associated with the stress of surgery 30 . This may indicate that AAs have a protective effect against surgical stresses that cause insulin resistance in postsurgical human patients 31 .…”

Metabolic Stress Response Attenuate by Oral Glucose Preoperatively in Patient Underwent Major Surgery with General Anesthesia

“…Levels of the cortisol hormone in circulation is a very strong predictor of an increases from insulin resistance as a result of post-surgical stress response [4]. The increased of cortisol level, resulting in insulin resistance and hyperglycaemia which have a significant effect on the healing process and lead to increase morbidity and mortality in patients undergoing surgery [2].…”

“…Mentioned that fasting more than 4 hours can lead to a change in the ratio of insulin glucagon. This situation, in turn, causes a stress response to surgical trauma and had a major influence on glycaemic control and insulin resistance [2]. The last few years there is a revision of the guidelines of several countries such as America, Canada and Europe that recommended reducing the preoperative fasting duration with the provision of water or a glucose solution for a few hours prior to elective surgery can improve patient comfort and safety [5].…”

“…These things stimulate metabolic changes and simultaneously causing postoperative stress response [1]. Surgery stimulate the increase of counter regulatory hormones (catecholamines, glucagon and cortisol) [2].…”