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Heart Surgery Ups Blood Sugar Levels
A new study has shown that nearly half of all heart surgery patients may experience blood sugar levels high enough to require temporary insulin treatment after their operation, even though they've never had diabetes.
The study, by researchers at the University of Michigan Health System, has shown that a significant minority of those patients might need to take medicines for days or even weeks after they leave the hospital, to help their blood sugar levels reach normal again.
Researchers found that obese patients, older patients, and those whose blood sugar levels were still high two days after their operation are most likely to need this kind of treatment.
The findings are based on a study, which included 1,362 patients who had certain heart and vascular operations at in 2006 and 2007.
Of them, 662 developed 'stress induced hyperglycemia" (SIH), or high blood sugar after surgery, and 87 needed blood sugar medicines when they left the hospital.
Stress-induced hyperglycemia occurs when the body reacts to the double insults of having an operation on the heart or major blood vessels, and of being cooled down by the heart-bypass machine to protect the heart muscle during surgery.
In the study, researchers looked at what happened after surgery, and what factors predicted a need for blood sugar treatment.
By far, the most telling sign that a person was likely to need such treatment - both in the hospital and as they went home - was their average blood sugar two days after surgery.
Those patients whose glucose levels were still high at this point were more than two and a half times more likely to need post-hospital medicines, even after other factors were considered.
Patients
who
had
a
body
mass
index
(BMI)
over
35,
which
is
consistent
with
a
diagnosis
of
obesity,
were
also
somewhat
more
likely
to
develop
SIH,
as
were
older
patients.
However,
these
factors
were
not
nearly
as
strongly
predictive
of
SIH
as
was
the
glucose
level
on
the
second
day
after
surgery.
Still, researchers said, overweight patients who carry their excess weight mainly around their waists, in the form of belly fat, are more likely to have metabolic syndrome, which involves both increased cardiovascular risk and increased risk of diabetes.
Although
the
study
didn't
look
at
whether
such
patients
later
developed
true
diabetes
or
pre-diabetes,
the
results
are
striking
enough
to
warrant
a
new
study.
It
will
recruit
patients
before
their
operations,
and
will
include
longer
follow-up
and
more
rigorous
testing
of
pre-surgery
and
post-hospitalization
blood
sugar
levels.
The
study
was
presented
at
American
Diabetes
Association's
Scientific
Sessions
in
San
Francisco
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