Table 2.
Perioperative glucose measurements and insulin regimens in patients underwent total pancreatectomy.
| Characteristics | Total | NDG | With pre-op DM | P value | ||
|---|---|---|---|---|---|---|
| SDG | LDG | |||||
| N, n (%) | 93 (100) | 41 (44.1) | 22 (23.7) | 30 (32.3) | – | |
| Preoperative glycemic status | ||||||
| Age at operation (years), mean ± SD | 59.9 ± 10.8 | 57.8 ± 11.2c | 59.5 ± 12.6 | 62.9 ± 8.1a | 0.145 | |
| BMI (kg/m2), mean ± SD | 22.06 ± 3.13 | 21.70 ± 2.79 | 21.27 ± 2.82c | 23.13 ± 3.57b | 0.063 | |
| DM duration (months), median (IQR) | 36 (6, 60) | NA | 5 (1, 12)c | 60 (36, 120)b | < 0.001 | |
| Family history of DM, n (%) | 18 (19.4) | 1 (2.4)c | 3 (13.6)c | 14 (46.7)ab | < 0.001 | |
| FBG (mmol/L), mean ± SD | 7.02 ± 2.16 | 5.72 ± 0.81bc | 7.91 ± 2.54a | 7.93 ± 2.21a | < 0.001 | |
| 2-h PBG (mmol/L), mean ± SD | 12.67 ± 5.07 | 5.30 ± 0.42bc | 15.87 ± 5.78ac | 11.55 ± 3.63ab | < 0.001 | |
| HbA1c (%), mean ± SD | 7.24 ± 1.72 | 5.48 ± 0.77bc | 8.09 ± 1.95ac | 6.95 ± 1.15ab | 0.007 | |
| Antidiabetic medications, n (%) | 43 (46.2) | – | 14 (63.6)c | 29 (96.7)b | 0.003 | |
| Oral agents only, n (%) | 23 (24.7) | – | 7 (31.8) | 16 (53.3) | 0.162 | |
| Insulin-containing regimes, n (%) | 20 (21.5) | 7 (31.8) | 13 (43.3) | 0.565 | ||
| Daily insulin dose (units/kg/day), mean ± SD | 0.53 ± 0.28 | – | 0.42 ± 0.24 | 0.59 ± 0.29 | 0.224 | |
| CAD, n (%) | 7 (7.5) | 2 (4.9) | 0 | 5 (16.7) | 0.056 | |
| Stroke, n (%) | 4 (4.3) | 0 | 1 (4.5) | 3 (10.0) | 0.080 | |
| DKD, n (%) | – | – | 0 | 0 | – | |
| DR, n (%) | – | – | 0 | 0 | – | |
| Postoperative hospitalized glucose measurement | ||||||
| Mean BG (mmol/L), mean ± SD | 10.99 ± 1.13 | 10.96 ± 1.06 | 11.23 ± 1.09 | 10.86 ± 1.25 | 0.497 | |
| Maximum BG (mmol/L), mean ± SD | 21.75 ± 3.19 | 21.80 ± 3.08 | 21.68 ± 2.90 | 21.72 ± 3.63 | 0.989 | |
| Minimum BG (mmol/L), mean ± SD | 4.25 ± 1.11 | 4.02 ± 1.06 | 4.68 ± 1.29 | 4.22 ± 0.96 | 0.077 | |
| 6 am BG (mmol/L), mean ± SD | 10.87 ± 1.97 | 10.62 ± 1.73 | 11.50 ± 2.43 | 10.74 ± 1.88 | 0.218 | |
| CV (%), mean ± SD | 31.54 ± 5.42 | 32.50 ± 4.94 | 30.31 ± 5.10 | 31.13 ± 6.19 | 0.281 | |
| Within the target range (4.4-10 mmol/L), n (%) | 2698 (43.3) | 1211 (43.0) | 569 (41.4) | 918 (45.1) | 0.101 | |
| Hyperglycemic events | ||||||
| 10.1-13.9 mmol/L, n (%) | 1976 (31.7) | 894 (31.8) | 450 (32.8) | 632 (31.0) | 0.560 | |
| 14.0-16.7 mmol/L, n (%) | 775 (12.5) | 358 (12.7) | 180 (13.1) | 237 (11.6) | 0.367 | |
| > 16.7 mmol/L, n (%) | 610 (9.8) | 270 (9.6) | 147 (10.7) | 193 (9.5) | 0.437 | |
| Hypoglycemic events | ||||||
| 3-3.8 mmol/L, n (%) | 83 (1.3) | 42 (1.5) | 14 (1.0) | 27 (1.3) | 0.473 | |
| < 3 mmol/L, n (%) | 10 (0.2) | 7 (0.2) | 0 | 3 (0.1) | 0.156 | |
| Patients with hypoglycemic events, n of patients/total n (%) | 42/93 (45.2) | 21/41 (51.2) | 9/22 (40.9) | 12/30 (40.0) | 0.620 | |
| 3-3.8 mmol/L, n of patients/total n (%) | 38/93 (40.9) | 19/41 (46.3) | 9/22 (40.9) | 10/30 (33.3) | 0.547 | |
| < 3 mmol/L, n of patients/total n (%) | 8/93 (8.6) | 5/41 (12.2) | 0 | 3/30 (10.0) | 0.311 | |
| Postoperative insulin regimen | ||||||
| Parenteral nutrition | ||||||
| Daily insulin dose (units/kg/day), mean ± SD | 1.20 ± 0.47 | 1.07 ± 0.40c | 1.13 ± 0.34c | 1.45 ± 0.56ab | 0.012 | |
| Daily insulin dose (units/day), mean ± SD | 69.03 ± 32.53 | 60.33 ± 27.55c | 63.32 ± 23.74c | 85.09 ± 38.79ab | 0.003 | |
| Insulin dose per 10g carbohydrate (units), mean ± SD | 5.70 ± 2.56 | 5.11 ± 2.02c | 4.93 ± 1.80c | 7.10 ± 3.15ab | 0.008 | |
| Enteral nutrition | ||||||
| Daily insulin dose (units/kg/day), mean ± SD | 0.36 ± 0.13 | 0.35 ± 0.16 | 0.34 ± 0.11 | 0.40 ± 0.11 | 0.267 | |
| Daily insulin dose (units/day), mean ± SD | 21.19 ± 8.98 | 20.30 ± 9.90 | 18.77 ± 7.22 | 24.05 ± 8.37 | 0.107 | |
| 1-month post-op | ||||||
| Daily insulin dose (units/kg/day), mean ± SD | 0.38 ± 0.12 | 0.36 ± 0.11c | 0.35 ± 0.12c | 0.42 ± 0.12ab | 0.031 | |
| Daily insulin dose (units/day), mean ± SD | 21.42 ± 8.01 | 20.22 ± 7.96c | 18.89 ± 6.98c | 24.91 ± 7.82ab | 0.011 | |
| Basal percentage (%), median (IQR) | 40.0 (32.1, 48.7) | 40.0 (29.4, 47.7) | 40.0 (33.3, 62.9) | 36.1 (30.8, 44.7) | 0.573 | |
pre-op, preoperative; DM, diabetes mellitus; NDG, nondiabetic group; SDG, short-duration diabetic group; LDG, long-duration diabetic group; BMI, body mass index; FBG, fasting blood glucose; PBG, postprandial blood glucose; HbA1c, glycosylated hemoglobin A1c; CAD, coronary artery disease; DKD, diabetic kidney disease; DR, diabetic retinopathy; BG, blood glucose; CV, coefficient of variation; post-op, postoperation.
aP < 0.05 vs NDG. bP < 0.05 vs SDG. cP < 0.05 vs LDG.
P values < 0.05 were shown in bold.