Fracture neck of femur (NOF) is a significant morbidity in the elderly patient and a significant burden on the healthcare system. Surgery induces a stress response resulting in hyperglycaemia, insulin resistance, and glucose intolerance (Diabetic triad). Furthermore, fasting pre operatively establishes a catabolic state. This diabetic state can last up to 3 weeks following surgery and therefore could be associated with the morbidity of diabetes. 26 patients with fracture NOF were enrolled in this preliminary study. Exclusion criteria included diabetics. Each underwent hemiarthroplasty or Dynamic Hip Screw fixation. Pre and post operative serum glucose levels were taken. 15 patients were selected to have pre and post operative serum insulin levels because of the expensive nature of the test. Normal glucose range = 4-6 mmol/l. Normal insulin range = 17.8 – 173 pmol/l. 21 of 26 patients exhibited post operative hyperglycaemia (range 5 - 16.4mmol/l). 7 of 15 patients tested for insulin remained in our pilot study where pre and post insulin levels were obtained. Insulin is a technically difficult level to take and samples are easily discarded. 6 of 7 Insulin levels showed marked elevation post operatively (range 17.5 – 595.8).Methods
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