Intravenous GLP-1 (7-36) amide for prevention of hyperglycemia during cardiac surgery: a randomized, double-blind, placebo-controlled study.

Abstract

OBJECTIVE:

The authors sought to evaluate the efficacy of an intravenous glucagon-like peptide-1 (GLP-1) infusion, compared with placebo, to mitigate intraoperative hyperglycemia.

DESIGN:

Prospective, double-blinded, randomized, placebo-controlled.

SETTING:

University hospital.

PARTICIPANTS:

Diabetic (non-insulin dependent) and non-diabetic patients undergoing elective cardiac surgery with cardiopulmonary bypass.

INTERVENTIONS:

Patients were randomized in a 1:1 fashion to GLP-1 (7-36) amide infusion (1.5 pmol/kg/min) or placebo. Insulin was administered intraoperatively to both groups per a standardized protocol.

MEASUREMENTS AND MAIN RESULTS:

A total of 77 patients were included for analysis (GLP-1, n = 37; placebo, n = 40). Mean blood glucose during cardiopulmonary bypass was 127.5 mg/dL and 142.5 mg/dL (p = 0.002) in the GLP-1 and placebo groups, respectively. Mean blood glucose values during the entire intraoperative course were 12.2 mg/dL lower for subjects given GLP-1 (95% CI 2.3, 22, p = 0.015), independent of time. During the period of cardiopulmonary bypass, mean blood glucose values in subjects given GLP-1 were 14.1 mg/dL lower than those who received placebo (95% CI 3.5, 24.8, p = 0.009), independent of time. The incidence of hypoglycemia did not differ significantly between the 2 groups.

CONCLUSIONS:

Administration of intravenous GLP-1 (7-36) amide to patients undergoing cardiac surgery significantly reduced their plasma glucose levels intraoperatively and may represent a novel therapeutic strategy to prevent perioperative hyperglycemia.

• Authors: Benjamin A Kohl, Mary S Hammond, Andrew J Cucchiara, E Andrew Ochroch
• Journal: Journal of cardiothoracic and vascular anesthesia (J Cardiothorac Vasc Anesth) Vol. 28 Issue 3 Pg. 618-25 (Jun 2014) ISSN: 1532-8422 [Electronic] United States
• PMID: 24144627 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Blood Glucose
• Hypoglycemic Agents
• Peptide Fragments
• glucagon-like peptide 1 (7-36)amide
• Glucagon-Like Peptide 1

Topics

• Adult
• Aged
• Aged, 80 and over
• Blood Glucose (metabolism)
• Cardiac Surgical Procedures (methods)
• Double-Blind Method
• Female
• Glucagon-Like Peptide 1 (administration & dosage, therapeutic use)
• Humans
• Hyperglycemia (prevention & control)
• Hypoglycemic Agents (administration & dosage, therapeutic use)
• Infusions, Intravenous
• Intraoperative Care
• Male
• Middle Aged
• Peptide Fragments (administration & dosage, therapeutic use)
• Prospective Studies
• Treatment Outcome