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World Journal of Surgery
Erschienen in:

10.01.2022 | Original Scientific Report

Preoperative Carbohydrate Drink Intake Increases Glycemic Variability in Patients with Type 2 Diabetes Mellitus in Total Joint Arthroplasty: A Prospective Randomized Trial

verfasst von: Bora Lee, So Yeon Kim, Byung Woo Cho, Sungmin Suh, Kwan Kyu Park, Yong Seon Choi

Erschienen in: World Journal of Surgery | Ausgabe 4/2022

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Abstract

Background

Preoperative carbohydrate treatment attenuates insulin resistance and improves metabolism to an anabolic state. Despite these benefits, impaired glycemic control and aspiration risk related to gastroparesis represent concerns for patients with diabetes undergoing surgery. This randomized controlled trial investigated the effects of oral carbohydrate therapy on perioperative glucose variability, metabolic responses, and gastric volume in diabetic patients undergoing elective total hip or knee arthroplasty.

Methods

Fifty diabetic patients scheduled to undergo elective total knee or hip arthroplasty during August 2019–October 2020 were randomly assigned to a control or carbohydrate therapy (CHO) group. CHO group of patients received a 400-mL carbohydrate drink 2–3 h before anesthesia; control group of patients underwent overnight fasting from midnight, one night before surgery. Blood glucose levels were measured before intake of the carbohydrate drink, before spinal anesthesia, preoperatively, immediately postoperatively, and 1 h postoperatively. Insulin level and gastric volume were measured before spinal anesthesia.

Results

The glucose variability of patients in the CHO group was significantly higher than that of those in the control group (16.5 vs. 10.1%, P = 0.008). Similarly, insulin resistance was higher in the CHO group than in the control group (8.5 vs. 2.7, P < 0.001). The gastric volume did not differ significantly between the groups (61.3 vs. 15.2 ml, P = 0.082).

Conclusions

Preoperative oral carbohydrate therapy increases glucose variability and insulin resistance in diabetic patients. Therefore, carbohydrate beverages should be cautiously administered to diabetic patients, considering metabolic and safety aspects.
Trial registration number ClinicalTrials.gov (No. NCT04013594).
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Metadaten
Titel
Preoperative Carbohydrate Drink Intake Increases Glycemic Variability in Patients with Type 2 Diabetes Mellitus in Total Joint Arthroplasty: A Prospective Randomized Trial
verfasst von
Bora Lee
So Yeon Kim
Byung Woo Cho
Sungmin Suh
Kwan Kyu Park
Yong Seon Choi
Publikationsdatum
10.01.2022
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 4/2022
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-021-06437-1

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