Development of optimal preoperative glycemic control in a diabetic model with chronic hyperglycemia

Research Project

Project/Area Number	18K16481
Research Category	Grant-in-Aid for Early-Career Scientists
Allocation Type	Multi-year Fund
Review Section	Basic Section 55050:Anesthesiology-related
Research Institution	Kobe University
Principal Investigator	Fujimoto Daichi 神戸大学, 医学部附属病院, 助教 (80792449)
Project Period (FY)	2018-04-01 – 2022-03-31
Project Status	Completed (Fiscal Year 2021)
Budget Amount *help	¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000) Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000) Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords	高血糖 / インスリン / 好中球 / 貪食能 / 糖尿病 / AKT / 手術 / 術前血糖管理 / 活性酸素 / 周術期管理
Outline of Final Research Achievements	This study investigated the optimal duration of glycemic control in chronically hyperglycemic mice before and after operation. The neutrophil works in the front line of immunity. We observed the changes of neutrophil functions with the length of insulin administration. The results showed that the phagocytic activity of neutrophils was improved to the same level as that of wild-type neutrophils before and after operation in the group that received insulin for a long period of time. There was a similar trend in ROS production preoperatively, but there was no statistically significant　difference between pre- and postoperatively. Insulin resistance was significantly improved in the third day of insulin administration. The optimal period of preoperative glycemic control may be the time until insulin resistance is lifted by long-term insulin therapy.
Academic Significance and Societal Importance of the Research Achievements	本研究の結果から、血糖コンロトール不良マウスにおいて、長期のインスリンによる血糖管理期間は、好中球の貪食能を非糖尿病群のそれと同程度まで改善することがわかり、インスリン抵抗性の改善と関連している可能性がある。動物の研究であるため人にどこまで当てはめられるかは不明であるが、例えば、血糖コンロトール不良患者の癌手術においては高血糖による合併症を減らすために、インスリン抵抗性が改善するまでインスリンによる血糖降下療法を行い、手術を迎えることが最も感染性雨の合併症を減少させ良い結果をもたらす可能性がある。