Perioperative Glucose and Insulin Changes in Major Urologic Surgeries

Perioperative Glucose and Insulin Changes in Major Urologic Surgeries

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.

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.

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