Perioperative Stress Hyperglycemia in General and Vascular Surgery Patients

Inclusion criteria: * Men and women without known history of diabetes with ages between 45 and 80 years undergoing non-cardiac general or vascular surgery * BMI ≥30 kg/m2 and pre-DM or DM by OGTT or HbA1c Exclusion criteria: * Patients prescribed or taking antihyperglycemic medications * Patients undergoing cardiac surgery or patients anticipated to require ICU care * Patients expected to be admitted less than 48-72 hours after surgery * Severely impaired renal function (eGFR \< 30 mL/min) or clinically significant hepatic failure * Treatment with oral (equivalent to prednisone \> 5 mg/day) or injectable corticosteroids * Mental condition rendering the subject unable to understand the nature, scope, and possible consequences of the study; unable to consent * Pregnant or breast feeding at time of enrollment * Prisoners * Patients undergoing gastrointestinal surgery or at high risk for gastrointestinal obstruction/ileus or expected to require gastrointestinal suction * Patients with delayed gastric emptying, pancreatic or gallbladder disease * Patients with personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 (MEN2)