Perioperative Glucose and Insulin Changes in Major Urologic Surgeries
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- To determine the perioperative glycemic changes longitudinally in patients undergoing major urologic surgeries.
Study Overview
Brief Summary
Urological surgery patients will have their blood glucose measured before, during, and after surgery. Blood glucose will be measured using a continuous glucose monitor (CGM) device. We hypothesize the presence of a hyperglycemic state towards the end of surgery due to increased metabolic demand.
Detailed Description
Surgical stress causes acute insulin resistance, increased circulating free-fatty acids, and reduced blood glucose uptake resulting in hyperglycemia. Intraoperative and postoperative glucose levels are typically only monitored in the diabetic or cardiac surgical patient. There is a lack of data on perioperative glucose levels in most prolonged surgeries and thus a barrier in determining the best glycemic management strategy to prevent or resolve acute insulin resistance and hyperglycemia. Obtaining blood glucose by CGM is less invasive and will avert disruption of current surgical pathways and standards of care while also producing reliable glucose measurements.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Adult (≥18 years) undergoing a major urologic surgery (proposed case duration >4 hours) at The University of Kansas Medical Center (KUMC)
- •English speaking
Exclusion Criteria
- •Diagnosis of Type 1 or Type 2 diabetes mellitus or an A1C > 6.5%
- •Pregnant or lactating
- •Known allergy to milk, soy, egg, wheat, peanuts, or tree nuts
- •Swallowing difficulties
Outcomes
Primary Outcomes
To determine the perioperative glycemic changes longitudinally in patients undergoing major urologic surgeries.
Time Frame: Perioperatively up to post-operative day 4
Interstitial blood glucose levels measured by Continuous Glucose Monitor (CGM) device, in mg/dL
Secondary Outcomes
- To determine the effect of perioperative insulin levels on glycemic variations in patients undergoing major urologic surgeries.(Perioperatively up to post-operative day 4)
- To determine the effect of perioperative insulin, C-peptide, and Free-Fatty Acid (FFA)(Perioperatively up to post-operative day 4)
Investigators
Jill Hamilton-Reeves, PhD RD LD
Associate Professor
University of Kansas Medical Center