Diabetes Mellitus Type II and Tissue Oxygenation

Influence of Diabetes Mellitus Type II on Tissue Oxygenation in the Perioperative Period

Status

Terminated

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT00554697

Enrollment

Registered

2007-11-07

Start date

2007-11-30

Completion date

2008-11-30

Last updated

2017-03-16

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes Mellitus, Type II

Keywords

tissue oxygenation, perioperative, outcome

Brief summary

The purpose of this study is to determine whether diabetics have decreased amounts of oxygen in the skin compared to non-diabetic individuals, and if the amount of oxygen in the skin changes when given more oxygen to breathe around the time of surgery. To do this, the investigators will be measuring the amount of oxygen in the skin of diabetic and non-diabetic individuals who will be undergoing abdominal surgery lasting 2-4 hours. These measurements will be taken at three different times.

Detailed description

The goal is to test the hypothesis that: 1) perioperative subcutaneous oxygenation (PsqO2) is lower in diabetic than non-diabetic patients; and, 2) supplemental oxygen provides less benefit in diabetic than non-diabetic patients. We propose a prospective case-control study which will include 30 Type II diabetics matched for age, sex, and race to 30 non-diabetic controls. Patients will be preselected from a population undergoing abdominal surgery and given supplemental inspired oxygen of 30 - 80% to PaO2 of approximately 150mmHg and/or 300mmHg at three timepoints in the perioperative period. PsqO2 will be measured with an IV-sized probe inserted through a small incision made in the skin. Data will be recorded and analyzed using unpaired two tailed t-test, Wilcoxon's ranked sum test, or repeated-measures analysis of variance (ANOVA) test as appropriate.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

35 Years to 65 Years

Healthy volunteers

Inclusion criteria

We will include 30 patients who have more than a five-year history of insulin-dependent type-2 diabetes mellitus and 30 non-diabetic patients meeting the following criteria: * 35 - 65 yrs old * BMI \< 30 * ASA class I - III * Abdominal surgery scheduled to last between 2- 4 hours For Non-diabetic group: previous BMP within the last year demonstrating glucose \< 126mg/dL For Diabetic group: * DMII defined as fasting plasma glucose of \> 126 mg/dL at time of diagnosis, now requiring insulin * At least one diabetes associated vasculopathy: coronary artery disease, diabetic nephropathy, hypertension, diabetic retinopathy, diffuse neuropathy, peripheral vascular disease, or a history of stroke

Exclusion criteria

* Pregnant * Immunocompromised: HIV/AIDS, on immunosuppressant therapy for any reason, or post-organ transplantation. * Infection or fever, or on glucocorticoids * Malignancy currently requiring radiation or chemotherapy * Liver or renal failure * Pancreatic insufficiency, dysautonomia, thyroid disease, Raynaud's syndrome, pathologic Allen-test, or any coagulopathies * Respiratory disease affecting ability to reach PaO2 of 300mmHg: COPD, emphysema, cystic fibrosis, asthma, pneumonia, PE * Smoker within the past 6 months or current alcohol abuse * Allergy to local anesthetic * For diabetics: DMI, other specific subtype, and gestational diabetics * We will also exclude patients with epidural catheter, to avoid the influence of regional anesthesia on tissue oxygenation \[37, 38\].

Design outcomes

Primary

Measure	Time frame
Diabetes Mellitus Type II and Tissue Oxygenation	5 years

Outcome results