AI Article Synopsis
- A 50-year-old man with type 2 diabetes had surgery for partial liver resection, experiencing frequent hypoglycemic episodes due to anti-insulin antibodies.
- The procedure required both general and epidural anesthesia, with administration of insulin to manage his blood sugar levels during and after surgery.
- Post-surgery, the patient faced severe fluctuations in blood sugar and required continuous glucose support, highlighting the challenges of managing diabetes influenced by anti-insulin antibodies.
Article Abstract
A 50-year-old man with type 2 diabetes mellitus was scheduled for laparoscopic partial liver resection. Six months prior to the surgery, he developed frequent hypoglycemic attacks and was diagnosed as anti-insulin antibody positive. The operation was performed under general anesthesia with epidural anesthesia. Intermit- tent and continuous insulin administration was required during liver resection due to persistent hyperglycemia. After termination of the liver resection, the patient exhibited uncontrolled hypo- and hypergly- cemia, and recovery from anesthesia was delayed due to severe hypoglycemia. He recovered immediately after 40% glucose administration. However, frequent glucose administration was required for two hours after transfer to the ICU due to hypoglycemia. It should be born in mind that preoperative poor glucose control might be caused by anti-insulin antibodies and lead to difficult perioperative glucose management.
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