Open Access, Peer-reviewed
eISSN 2093-758X
    J Korean Acad Nurs. 2011 Apr;41(2):157-164. Korean.
    Published online Apr 30, 2011.
    https://doi.org/10.4040/jkan.2011.41.2.157
    © 2011 Korean Society of Nursing Science
    Original Article

    Influence of Pre-operative Fasting Time on Blood Glucose in Older Patients

    Misuk Hong,1 and Haesang Yoon2
      • 1Nurse Anesthetist, Seoul National University Dental Hospital, Seoul, Korea.
      • 2Professor, Department of Nursing, Gachon University of Medicine & Science, Incheon, Korea.
    • Address reprint requests to: Yoon, Haesang. Department of Nursing, Gachon University of Medicine & Science, 534-2 Yeonsu-dong, Yeonsu-gu, Incheon 406-812, Korea. Tel: +82-32-820-4212, FAX: +82-32-820-4201, Email: hsyoon@gachon.ac.kr
    Received February 04, 2010; Accepted April 15, 2011.

    Abstract

    Purpose

    This study was performed to identify changes in blood glucose at preoperative fasting time in surgical patients over 60 yr.

    Methods

    Data collection was performed from July, 2008 through July, 2009. Participants consisted of 80 nondiabetic surgical patients. Blood glucose was checked from 3 to 5 times. The 5 times were 2-hr fasting on the pre-operative day (T1, n=80), 8 hr (T2, n=80), 10 hr (T3, n=17), 12 hr (T4, n=34) and 14 hr fasting on the day of the operation (T5, n=29).

    Results

    Of the patients, 27.5% had a blood glucose level of less than 79 mg/dL at T2; 17.6% at T3; 32.4% at T4; and 17.2% at T5. Mean blood glucose levels were 93.8 mg/dL at T1; 88.4 mg/dL at T2; 91.7 mg/dL at T3; 87.4 mg/dL at T4: and 94.1 mg/dL at T5. Blood glucose was the lowest at T2 (p<.001).

    Conclusion

    As 17.6-32.4% of the patients showed the blood glucose level of less than 79 mg/dL at 8-14 hr pre-operative fasting, the authors recommend that surgical patients >60 yr-of-age be observed for hypoglycemia during pre-operative fasting of more than 10 hr and that surgical patients >60 yr-of-age with risks for hypoglycemia be scheduled for operation within 10 hr preoperative fasting.

    Keywords
    Fasting; Blood glucose

    Figures

    Figure 1
    Research design.

    OP=operative; X=Blood sampling for blood glucose.

    Tables

    Table 1
    Physiological Characteristics (N=80)

    Table 2
    Comparison of Blood Glucose by Pre-operative Fasting Time (N=80)

    Table 3
    Comparison of Blood Glucose by Gender

    Table 4
    Correlation among Age, BMI, Hemoglobin, Hematocrit, Albumin and Blood Glucose during Pre-operative Fasting (N=80)

    Notes

    This article is a revision of the first author's master's thesis from Gachon University of Medicine & Science.

    References

      1. Bagshaw SM, Bellomo R, Jacka MJ, Egi M, Hart GK, George C. The impact of early hypoglycemia and blood glucose variability on outcome in critical illness. Critical Care 2009;13:R91.
      1. Bremer JP, Jauch-Chara K, Hallschmid M, Schmid S, Schultes B. Hypoglycemia unawareness in older compared with middle-aged patients with type 2 diabetes. Diabetes Care 2009;32:1513–1517.
      1. Brierley EJ, Broughton DL, James OF, Alberti KG. Reduced awareness of hypoglycaemia in the elderly despite an intact counter-regulatory response. QJM : Monthly Journal of the Association of Physicians 1995;88:439–445.
      1. Chang TH, Cho YH, Hong JG, Park JW. Effect of preoperative fasting on blood sugar and blood gas analysis. Korean Journal of Anesthesiology 1982;15:36–41.
      1. Ganong WF. In: Review of medical physiology. 22 ed. Tokyo: McGraw-Hill; 2005.
      1. Guettier JM, Gorden P. Hypoglycemia. Endocrinology and Metabolism Clinics of North America 2006;35:753–766. viii–viix.
      1. Huh IY, Baek CH, Lee JD, Shin JW, Gwak MJ. Effects of fluid therapy on serum glucose level in pediatric outpatients. Korean Journal of Anesthesiology 2006;50:158–161.
      1. Jeong G, Yoon H. The effect of anesthetic information on pre-operative anxiety, glucose, cortisol and epinephrine of patients undergoing tonsillectomy. Journal of Korean Biological Nursing Science 2007;9:143–151.
      1. Jin J, Wang GL, Shi X, Darlington GJ, Timchenko NA. The age-associated decline of glycogen synthase kinase 3 beta plays a critical role in the inhibition of liver regeneration. Molecular and Cellular Biology 2009;29:3867–3880.
      1. Kagansky N, Levy S, Rimon E, Cojocaru L, Fridman A, Ozer Z, et al. Hypoglycemia as a predictor of mortality in hospitalized elderly patients. Archives of Internal Medicine 2003;163:1825–1829.
      1. Statistics on the aged. Korea National Statistical Office. 2010 [Retrieved September 30, 2010].
        from http://kostat.go.kr/portal/korea/index.action.
      1. Kweon YS, Han YJ, Kim DC, Song HS. Effect of preoperative fasting time on blood glucose concentrations in children. Korean Journal of Anesthesiology 2000;39:528–533.
      1. Lee NH, Lee WK, Choi SH, Lee KY. Influence of replacement with ringer's lactate for preoperative NPO deficits on blood glucose concentration in children undergoing strabismus surgery. Anesthesia and Pain Medicine 2009;4:355–359.
      1. Mannucci E, Monami M, Mannucci M, Chiasserini V, Nicoletti P, Gabbani L, et al. Incidence and prognostic significance of hypoglycemia in hospitalized non-diabetic elderly patients. Aging Clinical and Experimental Research 2006;18:446–451.
      1. Matyka K, Evans M, Lomas J, Cranston I, Macdonald I, Amiel SA. Altered hierarchy of protective responses against severe hypoglycemia in normal aging in healthy men. Diabetes Care 1997;20:135–141.
      1. Meneilly GS, Cheung E, Tuokko H. Altered responses to hypoglycemia of healthy elderly people. The Journal of Clinical Endocrinology and Metabolism 1994;78:1341–1348.
      1. Morgan G, Mikhail M, Murray M. In: Clinical Anesthesiology. 4th ed. New York: McGraw-Hill; 2005.
      1. Mori S, Ito H. Hypoglycemia in the elderly. Japanese Journal of Medicine 1988;27:160–166.
      1. Statistics on major surgery. National Health Insurance Corporation. 2008 [Retrieved September 30, 2010].
        from http://www.nhic.or.kr/portal/site/main/menuitem.
      1. Ng CL. Hypoglycaemia in nondiabetic patients-an evidence. Australian Family Physician 2010;39:399–404.
      1. Oh SH, Kim IH, Choi SR, Chung CJ. Causes of patient dissatisfaction with anesthetic care. Korean Journal of Anesthesiology 2005;48:387–392.
      1. Ortiz-Alonso FJ, Galecki A, Herman WH, Smith MJ, Jacquez JA, Halter JB. Hypoglycemia counter regulation in elderly humans: Relationship to glucose levels. The American Journal of Physiology 1994;267:E497–E506.
      1. Shilo S, Berezovsky S, Friedlander Y, Sonnenblick M. Hypoglycemia in hospitalized nondiabetic older patients. Journal of the American Geriatrics Society 1998;46:978–982.
      1. Suh IS, Song SO, Park DP. Effects of starvation and perioperative fluid therapy on the blood glucose concentrations during anesthesia in children. Yeungnam University Journal of Medicine 1984;1:89–93.
      1. Definition of an older or elderly person. World Health Organization. 2010 [Retrieved October 30, 2010].
        from http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html.
    Cited by
    Crossref 5
    Google Scholar 
    PubMed Central 1
    Scopus 3
    MeSH Terms
    Fasting*
    Aged
    Aged, 80 and over
    Blood Glucose/analysis*
    Body Mass Index
    Female
    Hemoglobins/analysis
    Humans
    Hypoglycemia/blood
    Hypoglycemia/prevention & control
    Male
    Middle Aged
    Preoperative Care
    Risk
    Serum Albumin/analysis
    Sex Factors
    Time Factors
    Metrics
    Share
    Links to
    Figures
    slide

    1 / 1

    Tables
    slide
    slide
    slide
    slide

    1 / 4

    PERMALINK