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- Gustafsson, U OKarolinska Institutet (author)
Pre-operative carbohydrate loading may be used in type 2 diabetes patients
- Article/chapterEnglish2008
Publisher, publication year, extent ...
- 2008-03-07
- Malden, USA :Blackwell Publishing,2008
- printrdacarrier
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- LIBRIS-ID:oai:DiVA.org:oru-40512
- https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-40512URI
- https://doi.org/10.1111/j.1399-6576.2008.01599.xDOI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:117278845URI
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- Language:English
- Summary in:English
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- Background: Post-operative insulin resistance and hyperglycaemia are associated with an impaired outcome after surgery. Pre-operative oral carbohydrate loading (CHO) reduces post-operative insulin resistance with a reduced risk of hyperglycaemia during post-operative nutrition. Insulin-resistant diabetic patients have not been given CHO because the effects on pre-operative glycaemia and gastric emptying are unknown.Methods: Twenty-five patients (45-73 years) with type 2 diabetes [glycated haemoglobin (HbA1c) 6.2 +/- 0.2%, mean +/- SEM] and 10 healthy control subjects (45-72 years) were studied. A carbohydrate-rich drink (400 ml, 12.5%) was given with paracetamol 1.5 g for determination of gastric emptying.Results: Peak glucose was higher in diabetic patients than in healthy subjects (13.4 +/- 0.5 vs. 7.6 +/- 0.5 mM; P<0.01) and occurred later after intake (60 vs. 30 min; P<0.01). Glucose concentrations were back to baseline at 180 vs. 120 min in diabetic patients and healthy subjects, respectively (P<0.01). At 120 min, 10.9 +/- 0.7% and 13.3 +/- 1.2% of paracetamol remained in the stomach in diabetic patients and healthy, subjects respectively. Gastric half-emptying time (T50) occurred at 49.8 +/- 2.2 min in diabetics and at 58.6 +/- 3.7 min in healthy subjects (P<0.05). Neither peak glucose, glucose at 180 min, gastric T50, nor retention at 120 min differed between insulin (HbA1c 6.8 +/- 0.7%)- and non-insulin-treated (HbA1c 5.6 +/- 0.4%) patients.Conclusions: Type 2 diabetic patients showed no signs of delayed gastric emptying, suggesting that a carbohydrate-rich drink may be safely administrated 180 min before anaesthesia without risk of hyperglycaemia or aspiration pre-operatively.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
- Carbohydrate drink
- diabetes
- ERAS
- gastric emptying
- glucose control
- preoperative
- surgery
Added entries (persons, corporate bodies, meetings, titles ...)
- Nygren, JKarolinska Institutet (author)
- Thorell, AKarolinska Institutet (author)
- Soop, MKarolinska Institutet (author)
- Hellström, P MDepartment of Medicine, Gastroenterology Unit, Karolinska University Hospital, Solna, Stockholm (author)
- Ljungqvist, Olle,1954-Karolinska Institutet(Swepub:oru)olt (author)
- Hagström-Toft, EDepartment of Clinical Science, Intervention and Technology, Centre for Gastrointestinal Disease, Ersta Hospital, Karolinska Institutet, Stockholm; Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm (author)
- Karolinska InstitutetDepartment of Medicine, Gastroenterology Unit, Karolinska University Hospital, Solna, Stockholm (creator_code:org_t)
Related titles
- In:Acta Anaesthesiologica ScandinavicaMalden, USA : Blackwell Publishing52:7, s. 946-510001-51721399-6576
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