CRP predicts insulin need in T2DM after lumbar spinal canal stenosis surgery

Levels of C-reactive protein (CRP) appear to correlate with the insulin requirements of type 2 diabetes mellitus (T2DM) patients admitted for lumbar spinal canal stenosis surgery in the acute postoperative phase, a new study has found.

Researchers conducted a retrospective analysis of 49 patients corresponding to 286 records, collected during days when postoperative CRP levels were measured. The outcome of interest was the difference in the amount of daily insulin administered relative to the preoperative phase, with CRP, glucose intake and oral hypoglycaemic agent use as explanatory variables.

Linear mixed-effects models revealed a significant interaction between insulin needs and CRP levels. On average, patients required an additional 0.60 (95 percent confidence interval [CI], 0.33–0.86) U of insulin per day when their CRP levels increased to 1 mg/dL. A 1-percent difference in HbA1c further increased this effect size to 0.91 (95 percent CI, 0.52–1.30).

The other explanatory variables showed no individual significance in relation to insulin needs but improved the overall model performance upon inclusion.

In the present study, the final model was obtained by splitting the cohort into two: a training cohort, including 190 records from 32 patients, and a final test dataset, with 96 records from 17 patients. The final model achieved a Pearson’s correlation coefficient of 0.429 on cross-validation.

“The findings led us to speculate that CRP levels could be a metric for determining insulin requirements. Further prospective multicentre studies are needed to validate our findings,” said researchers.