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Abstract
The effects of insulin on glucose utilization were investigated in seven nonobese
patients before and 24 hours after elective cholecystectomy. Surgery was followed
by a significant increase in the circulating levels of glucose and insulin. The hypoglycemic
action of insulin was reduced by one third (p < 0.01) after surgery. In isolated fat
cells after surgery there was a significant overall reduction of 35% to 50% of the
effects of insulin on 3-0-methylglucose transport and lipogenesis at 1μmol/L of glucose
(where hexose transport is rate-limiting for insulin action). However, there was no
change in insulin sensitivity in these cells. The effects of insulin on lipogenesis
in adipocytes incubated with 100 μmol/L of glucose (where glucose metabolism is rate-limiting
for insulin action) and adipocyte insulin receptor binding were not influenced by
surgery. Insulin action in vivo and in vitro was not altered in five nonoperated control
subjects 24 hours after they were given the same type of nutritional support as the
cholecystectomy patients postoperatively. It was concluded that an elective moderate
surgical trauma induces a rapid and marked insulin resistance that is not the result
of postoperative nutritional restriction and involves a postreceptor binding alteration
of glucose transport.
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Article info
Publication history
Accepted:
April 6,
1988
Footnotes
☆Supported by grants from the Swedish Medical Research Council (19X D1034), Karolinska Institute, the Swedish Diabetes Association, and the Osterman, Folksam, Groschinsky, and Nordisk Insulin Foundations.
Identification
Copyright
© 1989 Published by Elsevier Inc.
