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Preoperative oral carbohydrates and postoperative insulin resistance
Department of Surgery, Karolinska Hospital Huddinge University Hospital, Stockholm, Sweden.
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Department of Surgery, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Endocrine Research Unit, Mayo Clinic and Foundation, Rochester MN, United States.
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1999 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 18, no 2, p. 117-120Article in journal (Refereed) Published
Abstract [en]

Infusions of carbohydrates before surgery have been shown to reduce postoperative insulin resistance. Presently, we investigated the effects of a carbohydrate drink, given shortly before surgery, on postoperative insulin sensitivity. Methods: Insulin sensitivity and glucose turnover (16, 6, 2H2]-D-glucose) were measured using hyperinsulinemic, normoglycemic clamps before and after elective surgery. Sixteen patients undergoing total hip replacement were randomly assigned to preoperative oral carbohydrate administration (CHO-H, n = 8) or the same amount of a placebo drink (placebo, n = 8) before surgery. Insulin sensitivity was measured before and immediately after surgery. Patients undergoing elective colorectal surgery were studied before surgery and 24 h postoperatively (CHO-C (n = 7), and fasted (n = 7), groups). The fasted group underwent surgery after an overnight fast. In both studies, the CHO groups received 800 ml of an isoosmolar carbohydrate rich beverage the evening before the operation (100 g carbohydrates), as well as another 400 ml (50 g carbohydrates) 2 h before the initiation of anesthesia. Results: Immediately after surgery, insulin sensitivity was reduced 37% in the placebo group (P < 0.05 vs. preoperatively) while no significant change was found in the CHO-H group (-16%, p = NS). During clamps performed 24 h postoperatively, insulin sensitivity and whole-body glucose disposal was reduced in both groups, but the reduction was greater compared to that in the CHO-C group (-49 ± 6% vs. -26 ± 8%, P < 0.05 fasted vs. CHO-C). Conclusions: Patients given a carbohydrate drink shortly before elective surgery displayed less reduced insulin sensitivity after surgery as compared to patients undergoing surgery after an overnight fast.

Place, publisher, year, edition, pages
Elsevier, 1999. Vol. 18, no 2, p. 117-120
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-63895DOI: 10.1016/S0261-5614(99)80063-6ISI: 000080306600011PubMedID: 10459075Scopus ID: 2-s2.0-0032915732OAI: oai:DiVA.org:oru-63895DiVA, id: diva2:1171093
Note

Funding agencies:

NIDDK NIH HHS R01 DK-41973 

NCRR NIH HHS RR00585 

Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2018-02-05Bibliographically approved

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Ljungqvist, Olle

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