Many patients without diabetes who undergo CABG surgery experience high glycemic variability in the postoperative period. However, the underlying mechanisms associated with glycemic variability after surgery are unknown. We used prospective observational data from 17 patients without diabetes who underwent CABG surgery and wore a Dexcom G6 pro CGM device during the perioperative period. We estimated the coefficient of variation [CV] using CGM values calibrated to point-of-care measurements. We categorized patients into high variability (CV > 10%; n = 5) and low variability (CV ≤ 10%; n = 12) during the first 24 hours after surgery. Metabolic pathways were identified from HILIC positive and Reverse Phase C18 analysis, with metabolites mapped to Kyoto Encyclopedia of Genes and Genomes (KEGG) human pathways using mummichog. Baseline clinical characteristics were similar between the groups. Branched-chain amino acid (BCAA) (e.g. isovalerylglutamic acid), lipids (e.g. acylcarnitine), and purine metabolism (e.g. cGMP) were associated with glycemic variability in the perioperative period, Figure. Metabolomics analysis suggests BCAA, acylcarnitines, and purine pathway metabolites are associated with glycemic variability after CABG surgery.
L. I. Guerrero arroyo: None. F. Zahedi tajrishi: None. M. Perez-guzman: None. J. Varghese: None. A. Abraham: None. M. R. Smith: None. F. J. Pasquel: Consultant; Dexcom, Inc., Medscape, Research Support; Dexcom, Inc., Ideal Medical Technologies.
National Institutes of Health (K23GM128221); Dexcom, Inc.
