Hyperglycemia is common after Coronary Artery Bypass Graft (CABG) surgery. Many patients with stress hyperglycemia experience poor outcomes after surgery. The metabolic pathways associated with glycemic control during this period remain unknown. We used prospective observational data from 17 patients without diabetes who underwent CABG surgery and wore blinded Dexcom G6 pro devices during the perioperative period to explore associations with changes in the metabolome. We estimated the percentage time spent in the target range (70-140 mg/dL) using CGM values calibrated to point-of-care measurements. We categorized patients according to time spent (≥70 or <70%) in the target range. Nine participants spent >70% of time in the target range, while eight participants spent <70% of time in the target range. 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 characteristics were similar between groups. Acylcarnitines and microbiome-related metabolites (e.g. 2-Dehydro-3-deoxy-D-gluconate 6-phosphate) were associated with worse glycemic control in the perioperative period, Figure. Metabolomics analysis suggests microbiome interactions and lipid pathways are associated with glycemic control after CABG surgery.
L. I. Guerrero arroyo: None. F. Zahedi tajrishi: None. J. Varghese: None. M. Perez-guzman: 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.
