Preoperative administration of oral carbohydrate-rich solutions: Comparison of glucometabolic responses and tolerability between patients with and without insulin resistance
Preoperative administration of oral carbohydrate-rich solutions: Comparison of glucometabolic responses and tolerability between patients with and without insulin resistance
复制标题
DOI：
10.1016/j.nut.2008.07.021
复制
发表时间：
2009-01-01
期刊：
影响因子：
4.4
通讯作者：
Tufan, Turgut
中科院分区：
文献类型：
--
作者：
Can, Mehmet Fatih;Yagci, Gokhan;Tufan, Turgut
目的：术前碳水化合物负荷与透明液体被认为是减少手术相关的胰岛素抵抗（IR）。然而，IR本身已经存在于一些择期手术的患者中。目前缺乏关于接受手术的IR患者术前口服碳水化合物负荷的安全性数据。我们的目的是评估术前碳水化合物负荷对糖代谢状态和胃内容物的患者和不IR。方法：34名非糖尿病患者接受了800毫升的特殊含碳水化合物的饮料在手术前的晚上，然后400毫升2小时手术前。在第二次给药前即刻、摄入饮料后40分钟和90分钟以及手术开始时采集血糖、胰岛素和皮质醇水平的血样。稳态模型评估IR评分>2.5的患者被认为患有IR。然后评估有IR和无IR患者之间的差异。结果：34例患者中有8例患有IR，其余26例没有。IR组血糖水平高于非IR组，但差异无统计学意义。最初升高的胰岛素浓度随后趋于降低至在非IR组中检测到的相应水平。皮质醇浓度在这两个groups.Conclusion：IR患者接受富含碳水化合物的饮料手术前似乎不会受到不利影响的饮料。此外，他们还获得了与这些饮料相关的可能的有益效果，并且像没有IR的患者一样，可以安全地进行手术。(C)2009年由Elsevier Inc.出版
Objective: Preoperative carbohydrate loading with clear fluids is thought to reduce surgery-related insulin resistance (IR). However, IR per se is already present in some patients scheduled for elective surgery. Data on the safety of preoperative oral carbohydrate loading in patients with IR undergoing surgery is lacking. We aimed to evaluate the effects of preoperative carbohydrate loading on the glucometabolic state and gastric content of patients with and without IR.Methods: Thirty-four non-diabetics received 800 mL of a special carbohydrate-containing drink on the evening before the operation and then 400 mL 2 h before surgery. Blood samples for glucose, insulin, and cortisol levels were taken immediately before the second dose, at 40 and 90 min after intake of the drink, and at the onset of surgery. Patients with a homeostasis model assessment IR score >2.5 were considered to have IR. The differences between patients with and without IR were then evaluated.Results: Eight of the 34 patients had IR and the remaining 26 did not. Glucose levels in the IR group were higher than those in the non-IR group, but the differences did not reach significance. The initially elevated insulin concentrations then tended to decrease to the corresponding levels detected in the non-IR group. The cortisol concentrations were similar in both groups.Conclusion: Patients with IR receiving a carbohydrate-rich drink before surgery appear not to be affected adversely by the beverage. Furthermore, they also obtain the probable beneficial effects related to these drinks and, like patients without IR, can undergo surgery safely. (C) 2009 Published by Elsevier Inc.