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World J Gastroenterol. Sep 7, 2009; 15(33): 4137-4142
Published online Sep 7, 2009. doi: 10.3748/wjg.15.4137
Problems associated with glucose toxicity: Role of hyperglycemia-induced oxidative stress
Shinji Kawahito, Hiroshi Kitahata, Shuzo Oshita
Shinji Kawahito, Hiroshi Kitahata, Shuzo Oshita, Department of Anesthesiology, Tokushima University Medical and Dental Hospital, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
Author contributions: Kawahito S, Kitahata H and Oshita S contributed equally to this work.
Correspondence to: Shinji Kawahito, MD, PhD, Department of Anesthesiology, Tokushima University Medical and Dental Hospital, 3-18-15 Kuramoto, Tokushima 770-8503, Japan. kawahito@clin.med.tokushima-u.ac.jp
Telephone: +81-88-6337181 Fax: +81-88-6337182
Received: May 26, 2009
Revised: June 27, 2009
Accepted: July 4, 2009
Published online: September 7, 2009
Abstract

Glucose homeostasis deficiency leads to a chronic increase in blood glucose concentration. In contrast to physiological glucose concentration, chronic superphysiological glucose concentration negatively affects a large number of organs and tissues. Glucose toxicity means a decrease in insulin secretion and an increase in insulin resistance due to chronic hyperglycemia. It is now generally accepted that glucose toxicity is involved in the worsening of diabetes by affecting the secretion of β-cells. Several mechanisms have been proposed to explain the adverse effects of hyperglycemia. It was found that persistent hyperglycemia caused the functional decline of neutrophils. Infection is thus the main problem resulting from glucose toxicity in the acute phase. In other words, continued hyperglycemia is a life-threatening risk factor, not only in the chronic but also the acute phase, and it becomes a risk factor for infection, particularly in the perioperative period.

Keywords: Glucose toxicity; Diabetes; Complication; Surgery; Surgical site infection; Emergency medicine; Critical care medicine