Abstract

Diabetic patients that perform limited amounts of exercise during perioperative periods tend to gain weight, and their glycemic control frequently deteriorates. However, temporary insulin therapy is associated with a risk of hypoglycemia. To investigate the efficacy and safety of preoperative liraglutide therapy, we performed a retrospective analysis of the cases of Japanese type 2 diabetes mellitus (T2DM) patients that underwent elective surgery.

Liraglutide therapy was initiated in patients with T2DM prior to elective surgery. Regular insulin was also administered in cases in which hyperglycemia (plasma glucose > 200mg/dl) was detected during operations. The glycemic level, the insulin dose during the perioperative period, body mass index (BMI), and perioperative complications were analyzed.

Seventy-three patients with T2DM (male/female: 40/33, age: 69.5±11.0, glycated hemoglobin (HbA1c): 7.8 ±1.3, BMI: 26.6±4.1) were administered liraglutide therapy before undergoing elective surgery; i.e., orthopedic operations (40 cases); cardiac catheterization for ischemic heart disease(12 cases); ophthalmological operations, including procedures for cataracts (13 cases); prostatectomy (2 cases); mastectomy (1 case); unilateral nephrectomy (1 case); total hysterectomy (1 case); total bladder extirpation (1 case); plastic surgery (1 case); and angioplasty for a hemodialysis shunt (1 case).

The preoperative administration of liraglutide therapy resulted in reductions in body weight (mean: -3.1 ± 2.0 kg) and good glycemic control throughout the perioperative period. Additional regular insulin was only required in 11 patients, who were prescribed ≤ 10 units each. No hypoglycemic episodes, delayed wound healing, or other complications were observed. The patients’ HbA1c levels remained within the normal range (mean: 6.8±0.8%) at 6 postoperative months. Liraglutide represents an effective therapeutic option for safely achieving good glycemic control in perioperative patients with T2DM, especially those who have a limited exercise ability or are at risk of hypoglycemia.