Impact of Anesthesia on Systemic and Cerebral Glucose Metabolism in Diabetes Patients Undergoing Neurosurgery “Updates of Diabetes and Neurosurgical Anesthesia”Jiang Tao and Liu Youtan*
Department of Anesthesiology, The University of Hong Kong Shenzhen Hospital, Hong Kong
- *Corresponding Author:
- Liu Youtan
Department of Anesthesiology
The University of Hong Kong Shenzhen Hospital
University of Hong Kong, Shenzhen, Guangdong
518000 P.R, Hong Kong
E-mail: [email protected]
Received date: July 29, 2013; Accepted date: September 17, 2013; Published date: September 24, 2013
Citation: Tao J, Youtan L (2013) Impact of Anesthesia on Systemic and Cerebral Glucose Metabolism in Diabetes Patients Undergoing Neurosurgery “Updates of Diabetes and Neurosurgical Anesthesia”. J Diabetes Metab 4:297. doi:10.4172/2155-6156.1000297
Copyright: © 2013 Tao J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Accumulating evidences demonstrate that patients with diabetes have higher perioperative risk of complications and longer hospital stays than patients without diabetes. Intensive insulin therapy (IIT) may improve outcomes in hyperglycemic neurosurgical patients. However, currently there is no adequate data/evidence regarding optimal insulin delivery protocols and targeted blood glucose concentration during IIT. IIT continues to be explored as a therapeutic method to reduce morbidity associated with derangements in glucose metabolism. Hypoglycemia is a common side effect of IIT with the potential to result in significant morbidity, especially in patients undergoing neurosurgical surgery. Surgical stimulus is a potent cause which may affect patients stress response and influences the metabolic and endocrine system, which can lead to electrolyte imbalance and decrease of blood insulin level and subsequently result in impairment of immune response and increase of blood glucose level. The stress response can be prevented by sufficient Depth of anesthesia. So the Anesthesiologists play a very important role in manipulating the blood glucose of the diabetes patients during the neurosurgical operations. Narcotics affect systemic and cerebral metabolism, and studies indicate that most of anesthetics have restraining effects on brain oxygen and glucose consumption. In order to better regulate the blood glucose, the anesthesiologists should master the actions of every anesthetics. IIT is a double-edged sword; more investigations should be focused on optimising blood glucose level for euglycemia maintenance in the intraoperative management of diabetes neurosurgical patients.