Background Pre-operative fasting leads to insulin resistance and increased metabolic stress in non-diabetic patients. Consumption of a carbohydrate drink may alleviate these deleterious effects. Patients with diabetes mellitus represent over 15% of the surgical population, yet concerns over hyperglycemia and aspiration have excluded patients with diabetes mellitus from studies assessing the utility of pre-operative carbohydrate drinks. Objective To assess for a clinically signiﬁcant increase in pre-operative blood glucose concentration (deﬁned as [2 mmol/L) in patients with diabetes consuming a pre-operative carbohydrate drink. Methods A prospective observational non-inferiority cohort study of 106 subjects with diabetes mellitus was undertaken to assess the effect of consuming a pre-operative carbohydrate drink in surgical patients. All patients with diabetes mellitus undergoing surgery (including but not limited to cardiac, neurologic, urologic, and general surgical procedures) were enrolled. Subjects were instructed to consume two carbohydrate-rich drinks, one before sleeping the evening prior to surgery and another on the day of surgery. Results In total, 43% of subjects were fully compliant with the pre-operative carbohydrate drink regimen. There were no signiﬁcant differences between the fully compliant and non-compliant subjects with respect to baseline charac- teristics. Consumption of a pre-operative carbohydrate drink was determined to be non-inferior to
World Journal of Surgery – Springer Journals
Published: Dec 27, 2017
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