Treatment of hyperglycemia for skeletal muscle metabolism in cancer patients after major surgery

20578 Background: Cancer and surgical stress interact to aggravate insulin resistance, protein catabolism and glutamine depletion in skeletal muscle. In the clinical setting, hyperglycemia and glutamine depletion were associated with poor outcome in critically ill patients. The present study was designed to explore the effects of insulin mediated euglycemia and moderate hyperglycemia on kinetics of protein and selected amino acids in skeletal muscle of cancer patients after major surgery. Methods: Adult cancer patients were studied after abdominal radical surgery. In each patient a 24-h period of insulin-mediated tight euglycemia (mean blood glucose: 5.8± 0.4 mmol/l) preceded or followed a 24-h period of moderate hyperglycemia (mean blood glucose: 9.6± 0.6 mmol/l) on the first and the second day after surgery (cross-over design with randomized sequence of treatments). Intensive (57±11 U/24-h) or conventional (25±5 U/24-h) insulin treatments were used to obtain euglycemia or moderate hyperglycemia during t...