Effect of carbohydrate feeding on insulin action in skeletal muscle after surgical trauma in the rat

Metabolic stress after surgery is associated with peripheral insulin resist ance. Recent studies have suggested that preoperative glucose can ameliorat e postoperative decreases in insulin-stimulated glucose disposal. In the pr esent experiments, we used a bowel-resection model of surgical trauma to te st the hypothesis that elevations of serum insulin induced by preoperative oral glucose or ad libitum feeding affects postoperative insulin-stimulated glucose uptake in skeletal muscle. Insulin-stimulated glucose transport wa s measured in vitro in soleus muscles after surgical trauma in fasted rots given oral glucose or watts before surgery. Insulin-stimulated glucose tran sport was also assessed in vitro in fasted or fed traumatized rats and non- traumatized control animals. In addition, stress hormones (glucagon, cortic osterone, and adrenaline) were measured before and after surgical trauma in fasted rats and rats fed ad libitum. In vitro skeletal-muscle insulin sens itivity and responsiveness were reduced postoperatively in fasted animals t hat received oral glucose loads before bowel resections and in rats fed ad libitum or fasted before surgery versus non-traumatized rats (all P < 0.05) . Stress-hormone concentrations after trauma did not differ between fed and fasted animals. In the current study, insulin sensitivity and responsivene ss were reduced in isolated skeletal muscles after bowel resection, but nei ther preoperative glucose supplementation nor free intake of mixed nutrient s ameliorated the development of postoperative insulin resistance. (C) Else vier Science Inc. 2001.