Does Glutamine Promote Benefits for Patients With Diabetes Mellitus Scheduled for Cardiac Surgery?

Vladimir V. Lomivorotov, Sergey M. Efremov, Vladimir A. Shmirev, Dmitry N. Ponomarev, Alexandr V. Svyatchenko, Mihail N. Deryagin, Vladimir N. Lomivorotov, Alexander M. Karaskov

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: We hypothesised, that perioperative use of N(2)-l-alanyl-l-glutamine confers cardioprotection and improves insulin resistance in diabetic patients with coronary artery disease operated under cardiopulmonary bypass. Methods: This double-blind, placebo-controlled, randomised study included 64 patients with diabetes mellitus type 2 who were scheduled for on-pump coronary artery bypass graft surgery. The protocol group (32 patients) and the control group (32 patients) glutamine (0.4g/kg/day of 20% solution of N(2)-l-alanyl-l-glutamine (" Dipeptiven®" Fresenius Kabi, Germany)) and placebo (0.9% NaCl), respectively. Perioperative concentration of troponin I in plasma was considered as the primary end-point. Whereas the secondary end-points were insulin resistance, insulin sensitivity, β-cell function, blood glucose, plasma triglycerides and free fatty acids concentrations. Insulin resistance, insulin sensitivity and β-cell function were measured using HOMA equation. Thermodilution method was used to measure haemodynamics in all the patients. Results: No differences have been found in perioperative dynamics of troponin I, insulin resistance, insulin sensitivity, β-cell function, blood glucose, plasma triglycerides free fatty acids concentrations and haemodynamics. Conclusion: Our results have failed to confirm the cardioprotective properties and modulatory effect on perioperative insulin resistance that are thought to be attributable to parenteral glutamine administration in dose 0.4. g/kg/day among cardiac patients with DM operated on under CPB.

Original languageEnglish (US)
Pages (from-to)360-365
Number of pages6
JournalHeart Lung and Circulation
Volume22
Issue number5
DOIs
StatePublished - May 2013

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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