The Quality of Preoperative Glycemic Control Predicts Insulin Sensitivity During Major Upper Abdominal Surgery: A Case-Control Study.

Objective: To examine the association of the quality of preoperative glycemic control and insulin sensitivity during major upper abdominal surgery.

Background: In cardiac surgery, glycated hemoglobin A (HbA), an indicator of glycemic control during the preceding 3 months, correlated with intraoperative insulin sensitivity. Furthermore, insulin resistance showed a significant association with adverse clinical outcomes.

Randomized controlled trial of the effect of hyperinsulinemic normoglycemia during liver resection on postoperative hepatic function and surgical site infection.

Background: While avoidance of preoperative fasting followed by hyperinsulinemic-normoglycemic clamp (HNC) reduced postoperative hepatic dysfunction and surgical site infection (SSI), the effect of HNC restricted to the intraoperative period is unknown. This study examined whether HNC restricted to the intraoperative period has similar effects in patients undergoing elective liver resections.

Methods: This study is a post hoc exploratory analysis of a randomized-controlled trial in patients undergoing hepatobiliary surgery and receiving the HNC as a potential preventative intervention to reduce infectious morbidity postoperatively.