Donatelli F, et al. - Since the study of insulin sensitivity state before surgery could help in treating postoperative hyperglycemia and preventing iatrogenic hypoglycemia, researchers analyzed postoperative insulin secretion in patients with a low insulin sensitivity (IR) before surgery vs patients with normal preoperative insulin sensitivity (IS). They examined 42 consecutive patients, randomized to receive either general anesthesia with epidural or PCA for abdominal surgery. In IR, reduced insulin secretion was observed irrespective of the type of anesthesia. Patients with normal insulin sensitivity demonstrated increased insulin secretion induced by PCA as well as decreased insulin secretion resulting from epidural. They recommended cautious administration of insulin post-operatively in patients with normal preoperative insulin sensitivity, while after surgery, insulin administration is advisable in patients with preoperative insulin resistance.