Hormones Increased in Response to Surgical Stress

Epinephrine
Norepinephrine
Cortisol
Growth Hormone
Glucagon

Diabetes patients undergoing surgery have acute stress.  As shown above, in response to this stress, the counterregulatory hormones Epinephrine, Norepinephrine, Cortisol, Growth Hormone. Glucagon increase.  The metabolic changes that occur secondary to these hormonal surges are shown below on the left.  There is a net production of glucose, lipid and protein.  The unchecked potential consequence of these metabolic changes are shown below, with the high glucoses leading to fluid and electrolyte abnormalities and potential diabetic ketoacidosis and hyperosmolar coma.  The point of this course is to learn how to keep your patients from developing these problems.  In the GOALS SECTION, this will be fleshed out.