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Journal of Gastrointestinal Surgery

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01-11-2011 | Original Article

Intensive Versus Conventional Insulin Therapy in Nondiabetic Patients Receiving Parenteral Nutrition After D2 Gastrectomy for Gastric Cancer: A Randomized Controlled Trial

Authors: Shougen Cao, Yanbing Zhou, Dong Chen, Zhaojian Niu, Dongsheng Wang, Liang Lv, Yu Li

Published in: Journal of Gastrointestinal Surgery | Issue 11/2011

Abstract

Background

This study was used to compare the effects of intensive insulin therapy with conventional insulin therapy on postoperative outcomes among nondiabetic patients receiving parenteral nutrition following D2 gastrectomy for gastric cancer.

Method

A total of 248 eligible patients were randomly assigned to receive intensive insulin therapy targeting a blood glucose level between 4.4 and 6.1 mmol/l [intensive group (n = 125)] or conventional insulin therapy targeting a blood glucose level less than 11.0 mmol/l [conventional group (n = 123)] during the postoperative period.

Results

Mean blood glucose concentrations were lower in the intensive group than in the conventional group. Severe hypoglycemia defined as blood glucose ≤2.2 mmol/l occurred in eight (6.4%) patients in the intensive group vs one (0.8%) patient in the conventional group (P = 0.036). One (0.8%) patient died in the intensive group vs two (1.6%) patients in the conventional group (P = 0.620). However, intensive insulin therapy significantly reduced overall postoperative complications rate (from 25.2% to 13.6%, P = 0.024). Moreover, both insulin resistance indicated as HOMA-IR and HLA-DR expression on monocytes were improved in the intensive group.

Conclusions

Intensive insulin therapy significantly reduced the postoperative short-term morbidity but not mortality among nondiabetic patients receiving parenteral nutrition after D2 gastrectomy. The benefits may be due to the suppression of insulin resistance and improvement of HLA-DR expression on monocytes.

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Title: Intensive Versus Conventional Insulin Therapy in Nondiabetic Patients Receiving Parenteral Nutrition After D2 Gastrectomy for Gastric Cancer: A Randomized Controlled Trial
Authors: Shougen Cao
Yanbing Zhou
Dong Chen
Zhaojian Niu
Dongsheng Wang
Liang Lv
Yu Li
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 11/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1654-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intensive Versus Conventional Insulin Therapy in Nondiabetic Patients Receiving Parenteral Nutrition After D2 Gastrectomy for Gastric Cancer: A Randomized Controlled Trial

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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