Diabetes Mellitus Type II and Tissue Oxygenation

Inclusion criteria:

We will include 30 patients who have more than a five-year history of insulin-dependent type-2 diabetes mellitus and 30 non-diabetic patients meeting the following criteria:

• 35 - 65 yrs old
• BMI < 30
• ASA class I - III
• Abdominal surgery scheduled to last between 2- 4 hours

For Non-diabetic group:

previous BMP within the last year demonstrating glucose < 126mg/dL

For Diabetic group:

• DMII defined as fasting plasma glucose of > 126 mg/dL at time of diagnosis, now requiring insulin
• At least one diabetes associated vasculopathy: coronary artery disease, diabetic nephropathy, hypertension, diabetic retinopathy, diffuse neuropathy, peripheral vascular disease, or a history of stroke

Exclusion Criteria:

• Pregnant
• Immunocompromised: HIV/AIDS, on immunosuppressant therapy for any reason, or post-organ transplantation.
• Infection or fever, or on glucocorticoids
• Malignancy currently requiring radiation or chemotherapy
• Liver or renal failure
• Pancreatic insufficiency, dysautonomia, thyroid disease, Raynaud's syndrome, pathologic Allen-test, or any coagulopathies
• Respiratory disease affecting ability to reach PaO2 of 300mmHg: COPD, emphysema, cystic fibrosis, asthma, pneumonia, PE
• Smoker within the past 6 months or current alcohol abuse
• Allergy to local anesthetic
• For diabetics: DMI, other specific subtype, and gestational diabetics
• We will also exclude patients with epidural catheter, to avoid the influence of regional anesthesia on tissue oxygenation [37, 38].