I recommend this paper
The authors might consider the possibility that hypoglycemic episodes during and immediately post-surgery could contribute to this problem. People undergoing surgery receive nothing by mouth for a prolonged period before surgery, then receive minimal glucose during and after, not enough to provide for the basal metabolic rate, much less the additional caloric requirements related to tissue damage and repair. It is not the norm, but perhaps should be, to monitor the patient’s glucose before, during, and after surgery until eating by mouth is re-established. This should be considered in light of recent research by Whitmer and others showing that a single significant episode of hypoglycemia in diabetics is associated with a higher risk of dementia. This could hold true for non-diabetics as well, particularly people who are ApoE4.
Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP, Selby JV. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA. 2009 Apr 15;301(15):1565-72. Abstract
View all comments by Mary Newport