Objective: To investigate the influence of intensive insulin therapy on the results of postoperative patients with gastric cancer.
Methods: 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.
Results: 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).
Conclusions: Intensive insulin therapy could counteract the state of high-inflammation and then improve the outcome of postoperative patients.
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Diabetes Technol Ther
January 2025
Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado, USA.
Adults with type 1 diabetes (T1D) are increasingly overweight or obese, in part due to intensive insulin therapy. Newer non-insulin medications targeting both hyperglycemia and weight loss are approved for people with type 2 diabetes. These drugs also reduce cardiovascular disease, the major cause of mortality in people with diabetes.
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Internal Medicine, Coimbatore Medical College, Coimbatore, IND.
Pancreatogenic diabetes also known as type 3c diabetes mellitus (DM) is a distinct entity often overlooked and misdiagnosed as type 2 diabetes. It results from exocrine pancreatic dysfunction involving both insulin and glucagon deficiencies due to damage to pancreatic beta and alpha cells. This case highlights a 46-year-old male presenting with diabetic ketoacidosis (DKA), a rare but severe complication of type 3c DM.
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Research & Analytics Department of AMGA (American Medical Group Association), Alexandria, VA, USA.
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Department of Medicine, Suburban Hospital, Johns Hopkins Medicine, Bethesda, Maryland.
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