Kotagal M, Symons RG, Hirsch IB, Umpierrez GE, Dellinger EP, Farrokhi ET, et al. Perioperative hyperglycemia and risk of adverse events among patients with and without diabetes. Ann Surg. 2015;261(1):97–103. Using the surgical outcomes database, an evaluation of surgical patients demonstrating that hyperglycemia in non-diabetic patientsis significantly associated with poor outcomes. PubMed PubMedCentral CrossRef
7.Mraovic B, Hipszer BR, Epstein RH, Pequignot EC, Parvizi J, Joseph JI. Preadmission hyperglycemia is an independent risk factor for in-hospital symptomatic pulmonary embolism after major orthopedic surgery. J Arthroplasty. 2010;25(1):64–70.PubMed CrossRef
8.van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345(19):1359–67.PubMed CrossRef
9.Furnary AP, Gao G, Grunkemeier GL, Wu Y, Zerr KJ, Bookin SO, et al. Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2003;125(5):1007–21.PubMed CrossRef
10.Inzucchi SE. Clinical practice. Management of hyperglycemia in the hospital setting. N Engl J Med. 2006;355(18):1903–11.PubMed CrossRef
11.Kitabchi AE, Freire AX, Umpierrez GE. Evidence for strict inpatient blood glucose control: time to revise glycemic goals in hospitalized patients. Metabolism. 2008;57(1):116–20.PubMed CrossRef
12.Kosiborod M, Inzucchi SE, Spertus JA, Wang Y, Masoudi FA, Havranek EP, et al. Elevated admission glucose and mortality in elderly patients hospitalized with heart failure. Circulation. 2009;119(14):1899–907.PubMed CrossRef
13.Bower WF, Jin L, Underwood MJ, Lee JF, Lee KF, Lam YH, et al. Overt diabetes mellitus adversely affects surgical outcomes of noncardiovascular patients. Surgery. 2010;147(5):670–5.PubMed CrossRef
14.Schmeltz LR, DeSantis AJ, Thiyagarajan V, Schmidt K, O’Shea-Mahler E, Johnson D, et al. Reduction of surgical mortality and morbidity in diabetic patients undergoing cardiac surgery with a combined intravenous and subcutaneous insulin glucose management strategy. Diabetes Care. 2007;30(4):823–8.PubMed CrossRef
15.Umpierrez GE, Kitabchi AE. ICU care for patients with diabetes. Curr Opin Endocrinol. 2004;11:75–81.CrossRef
16.Abdelmalak BB, Knittel J, Abdelmalak JB, Dalton JE, Christiansen E, Foss J, et al. Preoperative blood glucose concentrations and postoperative outcomes after elective non-cardiac surgery: an observational study. Br J Anaesth. 2014;112(1):79–88.PubMed CrossRef
17.Buehler L, Fayfman M, Alexopoulos AS, Zhao L, Farrokhi F, Weaver J, et al. The impact of hyperglycemia and obesity on hospitalization costs and clinical outcome in general surgery patients. J Diabet Complications. 2015;29(8):1177–82.CrossRef
18.Noordzij PG, Boersma E, Schreiner F, Kertai MD, Feringa HH, Dunkelgrun M, et al. Increased preoperative glucose levels are associated with perioperative mortality in patients undergoing noncardiac, nonvascular surgery. Eur J Endocrinol. 2007;156(1):137–42.PubMed CrossRef
19.Pomposelli JJ, Baxter 3rd JK, Babineau TJ, Pomfret EA, Driscoll DF, Forse RA, et al. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. JPEN J Parenter Enteral Nutr. 1998;22(2):77–81.PubMed CrossRef
20.Akhtar ST, Mahmood K, Naqvi IH, Vaswani AS. Inpatient management of type 2 diabetes mellitus: does choice of insulin regimen really matter? Pak J Med Sci. 2014;30(4):895–8.PubMed PubMedCentral
21.McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Crit Care Clin. 2001;17(1):107–24.PubMed CrossRef
22.Smiley DD, Umpierrez GE. Perioperative glucose control in the diabetic or nondiabetic patient. South Med J. 2006;99(6):580–9. quiz 90–1.PubMed CrossRef
23.Cook CB, Kongable GL, Potter DJ, Abad VJ, Leija DE, Anderson M. Inpatient glucose control: a glycemic survey of 126 U.S. hospitals. J Hosp Med. 2009;4(9):E7–14.PubMed CrossRef
24.Lipshutz AK, Gropper MA. Perioperative glycemic control: an evidence-based review. Anesthesiology. 2009;110(2):408–21.PubMed
25.McDonnell ME, Umpierrez GE. Insulin therapy for the management of hyperglycemia in hospitalized patients. Endocrinol Metab Clin North Am. 2012;41(1):175–201.PubMed PubMedCentral CrossRef
26.McMahon M, Gerich J, Rizza R. Effects of glucocorticoids on carbohydrate metabolism. Diabetes Metab Rev. 1988;4(1):17–30.PubMed CrossRef
27.Chan TM. The permissive effects of glucocorticoid on hepatic gluconeogenesis. Glucagon stimulation of glucose-suppressed gluconeogenesis and inhibition of 6-phosphofructo-1-kinase in hepatocytes from fasted rats. J Biol Chem. 1984;259(12):7426–32.PubMed
28.Hotamisligil GS, Murray DL, Choy LN, Spiegelman BM. Tumor necrosis factor alpha inhibits signaling from the insulin receptor. Proc Natl Acad Sci U S A. 1994;91(11):4854–8.PubMed PubMedCentral CrossRef
29.Lang CH, Dobrescu C, Bagby GJ. Tumor necrosis factor impairs insulin action on peripheral glucose disposal and hepatic glucose output. Endocrinology. 1992;130(1):43–52.PubMed
30.Stentz FB, Umpierrez GE, Cuervo R, Kitabchi AE. Proinflammatory cytokines, markers of cardiovascular risks, oxidative stress, and lipid peroxidation in patients with hyperglycemic crises. Diabetes. 2004;53(8):2079–86.PubMed CrossRef
31.del Aguila LF, Claffey KP, Kirwan JP. TNF-alpha impairs insulin signaling and insulin stimulation of glucose uptake in C2C12 muscle cells. Am J Physiol. 1999;276(5 Pt 1):E849–55.PubMed
32.Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002;106(16):2067–72.PubMed CrossRef
33.Fan J, Li YH, Wojnar MM, Lang CH. Endotoxin-induced alterations in insulin-stimulated phosphorylation of insulin receptor, IRS-1, and MAP kinase in skeletal muscle. Shock. 1996;6(3):164–70.PubMed CrossRef
34.Robinson LE, van Soeren MH. Insulin resistance and hyperglycemia in critical illness: role of insulin in glycemic control. AACN Clin Issues. 2004;15(1):45–62.PubMed CrossRef
35.Turina M, Fry DE, Polk Jr HC. Acute hyperglycemia and the innate immune system: clinical, cellular, and molecular aspects. Crit Care Med. 2005;33(7):1624–33.PubMed CrossRef
36.Delamaire M, Maugendre D, Moreno M, Le Goff MC, Allannic H, Genetet B. Impaired leucocyte functions in diabetic patients. Diabet Med. 1997;14(1):29–34.PubMed CrossRef
37.Jakelic J, Kokic S, Hozo I, Maras J, Fabijanic D. Nonspecific immunity in diabetes: hyperglycemia decreases phagocytic activity of leukocytes in diabetic patients. Med Arh. 1995;49(1–2):9–12.PubMed
38.Manzella D, Barbieri M, Rizzo MR, Ragno E, Passariello N, Gambardella A, et al. Role of free fatty acids on cardiac autonomic nervous system in noninsulin-dependent diabetic patients: effects of metabolic control. J Clin Endocrinol Metab. 2001;86(6):2769–74.PubMed CrossRef
39.Havmoeller R, Reinier K, Teodorescu C, Ahmadi N, Kwok D, Uy-Evanado A, et al. Elevated plasma free fatty acids are associated with sudden death: a prospective community-based evaluation at the time of cardiac arrest. Heart Rhythm. 2014;11(4):691–6.PubMed PubMedCentral CrossRef
40.Oliver MF, Opie LH. Effects of glucose and fatty acids on myocardial ischaemia and arrhythmias. Lancet. 1994;343(8890):155–8.PubMed CrossRef
41.Yamagishi K, Folsom AR, Steffen LM, Investigators AS. Plasma fatty acid composition and incident ischemic stroke in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Cerebrovasc Dis. 2013;36(1):38–46.PubMed CrossRef
42.Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer RG, et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27(2):553–97.PubMed CrossRef
43.Rains JL, Jain SK. Oxidative stress, insulin signaling, and diabetes. Free Radic Biol Med. 2011;50(5):567–75.PubMed PubMedCentral CrossRef
44.Ceriello A, Quagliaro L, D’Amico M, Di Filippo C, Marfella R, Nappo F, et al. Acute hyperglycemia induces nitrotyrosine formation and apoptosis in perfused heart from rat. Diabetes. 2002;51(4):1076–82.PubMed CrossRef
45.Farrokhi F, Smiley D, Umpierrez GE. Glycemic control in non-diabetic critically ill patients. Best Pract Res Clin Endocrinol Metab. 2011;25(5):813–24.PubMed PubMedCentral CrossRef
46.Stegenga ME, van der Crabben SN, Blumer RM, Levi M, Meijers JC, Serlie MJ, et al. Hyperglycemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia. Blood. 2008;112(1):82–9.PubMed PubMedCentral CrossRef
47.Yamagishi SI, Edelstein D, Du XL, Brownlee M. Hyperglycemia potentiates collagen-induced platelet activation through mitochondrial superoxide overproduction. Diabetes. 2001;50(6):1491–4.PubMed CrossRef
48.Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15(4):353–69.PubMed CrossRef
49.Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119–31.PubMed PubMedCentral CrossRef
50.Jacobi J, Bircher N, Krinsley J, Agus M, Braithwaite SS, Deutschman C, et al. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Crit Care Med. 2012;40(12):3251–76.PubMed CrossRef
51.Dhatariya K, Levy N, Kilvert A, Watson B, Cousins D, Flanagan D, et al. NHS diabetes guideline for the perioperative management of the adult patient with diabetes. Diabet Med. 2012;29(4):420–33.PubMed CrossRef
52.Umpierrez GE, Hellman R, Korytkowski MT, Kosiborod M, Maynard GA, Montori VM, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(1):16–38.PubMed CrossRef
53.Pasquel FJ, Gomez-Huelgas R, Anzola I, Oyedokun F, Haw JS, Vellanki P, et al. Predictive value of admission hemoglobin A1c on inpatient glycemic control and response to insulin therapy in medicine and surgery patients with type 2 diabetes. Diabetes Care. 2015;38(12):e202–3.PubMed CrossRef
54.Gustafsson UO, Thorell A, Soop M, Ljungqvist O, Nygren J. Haemoglobin A1c as a predictor of postoperative hyperglycaemia and complications after major colorectal surgery. Br J Surg. 2009;96(11):1358–64.PubMed CrossRef
55.Halkos ME, Lattouf OM, Puskas JD, Kilgo P, Cooper WA, Morris CD, et al. Elevated preoperative hemoglobin A1c level is associated with reduced long-term survival after coronary artery bypass surgery. Ann Thorac Surg. 2008;86(5):1431–7.PubMed CrossRef
56.Hudson CC, Welsby IJ, Phillips-Bute B, Mathew JP, Lutz A, Chad Hughes G, et al. Glycosylated hemoglobin levels and outcome in non-diabetic cardiac surgery patients. Can J Anaesth. 2010;57(6):565–72.PubMed CrossRef
57.Faritous Z, Ardeshiri M, Yazdanian F, Jalali A, Totonchi Z, Azarfarin R. Hyperglycemia or high hemoglobin A1C: which one is more associated with morbidity and mortality after coronary artery bypass graft surgery? Ann Thorac Cardiovasc Surg. 2014;20(3):223–8.PubMed CrossRef
58.Underwood P, Seiden J, Carbone K, Chamarthi B, Turchin A, Bader AM, et al. Early identification of individuals with poorly controlled diabetes undergoing elective surgery: improving A1C testing in the preoperative period. Endocr Pract. 2015;21(3):231–6.PubMed CrossRef
59.Kallio PJ, Nolan J, Olsen AC, Breakwell S, Topp R, Pagel PS. Anesthesia preoperative clinic referral for elevated Hba1c reduces complication rate in diabetic patients undergoing total joint arthroplasty. Anesth Pain Med. 2015;5(3):e24376.PubMed PubMedCentral CrossRef
60.Korytkowski M, McDonnell ME, Umpierrez GE, Zonszein J. Patient guide to managing hyperglycemia (high blood sugar) in the hospital. J Clin Endocrinol Metab. 2012;97(1):27A–8.PubMed CrossRef
61.Mendez CE, Umpierrez G. Management of the hospitalized patient with type 1 diabetes mellitus. Hosp Pract (1995). 2013;41(3):89–100.CrossRef
62.Seki S. Clinical features of hyperosmolar hyperglycemic nonketotic diabetic coma associated with cardiac operations. J Thorac Cardiovasc Surg. 1986;91(6):867–73.PubMed
63.Brenner WI, Lansky Z, Engelman RM, Stahl WM. Hyperosomolar coma in surgical patients: an latrogenic disease of increasing incidence. Ann Surg. 1973;178(5):651–4.PubMed PubMedCentral CrossRef
64.Joshi GP, Chung F, Vann MA, Ahmad S, Gan TJ, Goulson DT, et al. Society for ambulatory anesthesia consensus statement on perioperative blood glucose management in diabetic patients undergoing ambulatory surgery. Anesth Analg. 2010;111(6):1378–87.PubMed CrossRef
65.Mendez CE, Umpierrez GE. Pharmacotherapy for hyperglycemia in noncritically Ill hospitalized patients. Diabetes Spectr. 2014;27(3):180–8.PubMed PubMedCentral CrossRef
66.Deusenberry CM, Coley KC, Korytkowski MT, Donihi AC. Hypoglycemia in hospitalized patients treated with sulfonylureas. Pharmacotherapy. 2012;32(7):613–7.PubMed CrossRef
60.•

文摘

Hyperglycemia is a frequent manifestation of critical and surgical illness, resulting from the acute metabolic and hormonal changes associated with the response to injury and stress (Umpierrez and Kitabchi, Curr Opin Endocrinol. 11:75–81, 2004; McCowen et al., Crit Care Clin. 17(1):107–24, 2001). The exact prevalence of hospital hyperglycemia is not known, but observational studies have reported a prevalence of hyperglycemia ranging from 32 to 60 % in community hospitals (Umpierrez et al., J Clin Endocrinol Metab. 87(3):978–82, 2002; Cook et al., J Hosp Med. 4(9):E7–14, 2009; Farrokhi et al., Best Pract Res Clin Endocrinol Metab. 25(5):813–24, 2011), and 80 % of patients after cardiac surgery (Schmeltz et al., Diabetes Care 30(4):823–8, 2007; van den Berghe et al., N Engl J Med. 345(19):1359–67, 2001). Retrospective and randomized controlled trials in surgical populations have reported that hyperglycemia and diabetes are associated with increased length of stay, hospital complications, resource utilization, and mortality (Frisch et al., Diabetes Care 33(8):1783–8, 2010; Kwon et al., Ann Surg. 257(1):8–14, 2013; Bower et al., Surgery 147(5):670–5, 2010; Noordzij et al., Eur J Endocrinol. 156(1):137–42, 2007; Mraovic et al., J Arthroplasty 25(1):64–70, 2010). Substantial evidence indicates that correction of hyperglycemia reduces complications in critically ill, as well as in general surgery patients (Umpierrez et al., J Clin Endocrinol Metab. 87(3):978–82, 2002; Clement et al., Diabetes Care 27(2):553–97, 2004; Pomposelli et al., JPEN J Parented Enteral Nutr. 22(2):77–81, 1998). This manuscript reviews the pathophysiology of stress hyperglycemia during anesthesia and the perioperative period. We provide a practical outline for the diagnosis and management of preoperative, intraoperative, and postoperative care of patients with diabetes and hyperglycemia.