{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:18:34Z","timestamp":1787894314582,"version":"build-2784847793"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify factors associated with postoperative hypoglycemia among inpatients with type 2 diabetes mellitus (T2DM) receiving laparoscopic colorectal cancer (CRC) resection, and to construct a predictive model for assessing hypoglycemia risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study collected data on hospitalized T2DM patients who underwent laparoscopic CRC resection between January 2021 and June 2023, and randomized them into a training and an internal validation cohorts in a 7:3 ratio. Multivariate logistic regression was used to build a prediction model for in-hospital hypoglycemia after laparoscopic CRC resection and identify independent predictors for level 1 and level 2 hypoglycemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 720 hospitalized T2DM patients receiving laparoscopic CRC resection, the overall incidence of postoperative hypoglycemia was 16.7% (120 patients), including 98 level 1 cases and 22 level 2 cases. A multivariable predictive model was developed using five independent predictors: long T2DM duration, low preoperative day-1 fasting plasma glucose (FPG), American Society of Anes- thesiologists physical status grade &amp;gt; II, prolonged postoperative fasting, and prior long-term insulin therapy. The model yielded an area under the receiver operating characteristic curve (AUC) of 0.817 (95% confidence interval [CI], 0.774-0.859) in the training cohort and 0.751 (95% CI, 0.669-0.833) in the validation cohort for hypoglycemia prediction. Level 1 postoperative hypoglycemia was independently predicted by long T2DM duration, low preoperative day-1 FPG, and prolonged postoperative fasting; while level 2 hypoglycemia was associated with low body mass index (BMI), low pre- operative day-1 FPG, and elevated neutrophil (NEUT) proportion on postoperative day 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The nomogram prediction model constructed in this study provided reliable risk estimation for postoperative hypoglycemia in hospitalized patients with T2DM undergoing laparoscopic CRC resection, and might serve as a practical adjunct to inform individualized clinical decisions and optimize perioperative glycemic management.<\/jats:p>\n                  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