FAT EMULSIONS AS AN IDEAL NONPROTEIN ENERGY-SOURCE UNDER SURGICAL STRESS FOR DIABETIC-PATIENTS

We studied the possibility of fat emulsions being a major calorie sour ce, and if possible, a new infusion protocol without glucose for diabe tic patients undergoing surgery. High dosages of fat emulsions and ami no acids (HFHA infusions) were investigated as a substitute for conven tional glucose-based infusions for 7 days after surgery. Without insul in and glucose, blood glucose was kept within the normal range, in spi te of the fact that patients were recovering from major surgeries. Blo od triglyceride and fatty free acids (FFA )increased after the start o f the HFHA infusions but remained within normal range. Liver function tests and nutritional states estimated by nitrogen balance or rapid tu rnover proteins were no different from those of the conventional gluco se-based infusion, but the significance of the HFHA infusion lies in t he fact that it was applied to patients in whom it was impossible to a dminister enough calories by using the conventional glucose-based infu sion, even if insulin was used. This HFHA infusion, which enables easy blood glucose control, sufficient calorie supply without complication s, and is also nutritionally equivalent to the conventional glucose-ba sed infusion, can be a new nutritional option for postoperative patien ts with impaired glucose tolerance.