Time course change of the insulin requirements during the perioperative period in hepatectomy and pancreatectomy by using an artificial pancreas STG-55

Sanae Teshigawara; Atsuhito Tone; Akihiro Katayama; Yusuke Imai; Toshihisa Tahara; Mayumi Senoo; Satoko Watanabe; Mitsuhiro Kaneto; Yasuyuki Shimomura; Chiaki Yagi; Hiroki Kajioka; Toru Kojima; Takefumi Niguma; Tatsuaki Nakatou

doi:10.1007/s13340-023-00623-3

Time course change of the insulin requirements during the perioperative period in hepatectomy and pancreatectomy by using an artificial pancreas STG-55

Diabetol Int. 2023 Apr 1;14(3):262-270. doi: 10.1007/s13340-023-00623-3. eCollection 2023 Jul.

Affiliations

¹ Department of Internal Medicine, Diabetes Center, Okayama Saiseikai General Hospital, 2-25 Kokutaicho, Kita-Ku, Okayama, 700-8511 Japan.
² Department of Diabetology and Metabolism, National Hospital Organization, Okayama Medical Center, Okayama, Japan.
³ Department of Surgery, Okayama Saiseikai General Hospital, Okayama, Japan.

Abstract

Introduction: To investigate changes in insulin requirements over time in patients who underwent hepatectomy and pancreatectomy with perioperative glycemic control by an artificial pancreas (STG-55).

Materials and methods: We included 56 patients (22 hepatectomies and 34 pancreatectomies) who were treated with an artificial pancreas in the perioperative period and investigated the differences in insulin requirements by organ and surgical procedure.

Results: The mean intraoperative blood glucose level and total insulin doses were higher in the hepatectomy group than in the pancreatectomy group. The dose of insulin infusion increased in hepatectomy, especially early in surgery, compared to pancreatectomy. In the hepatectomy group, there was a significant correlation between the total intraoperative insulin dose and Pringle time, and in all cases, there was a correlation with surgical time, bleeding volume, preoperative CPR, preoperative TDD, and weight.

Conclusions: Perioperative insulin requirements may be mainly dependent on the surgical procedure, invasiveness, and organ. Preoperative prediction of insulin requirements for each surgical procedure contributes to good perioperative glycemic control and improvement of postoperative outcomes.

Keywords: Artificial pancreas; Hepatectomy; Insulin requirements; Pancreatectomy; Perioperative glycemic management.

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