Intake of a carbohydrate-containing fluid is reported to improve insulin-like growth factor levels , reduce hunger , nausea , and length of stay , and attenuate the decrease in whole-body insulin sensitivity and endogenous glucose release .
Amino acid supplementation is reported to reduce muscle atrophy and accelerate return of functional mobility .
There is limited evidence for nutritional supplementation in THR and TKR pathways ; however , the low risk profile and potential benefits to adjunctive treatment methods , such as exercise programs , suggest nutritional supplements may have a role .
Optimizing nutritional status pre-operatively may help manage the surgical stress response , with a particular benefit for undernourished , frail , or elderly individuals
Nutritional supplements can influence outcomes for individuals undergoing major surgery , particularly in older persons whose functional reserve is limited .
Accelerating recovery from total hip replacement ( THR ) and total knee replacement ( TKR ) may offer significant benefits .
Therefore , we explored the role of nutritional supplements in improving recovery following THR and TKR .
Preoperative oral carbohydrate treatment attenuates endogenous glucose release 3 days after surgery.
BACKGROUND & AIMS Postoperative metabolism is characterised by insulin resistance and a negative whole-body nitrogen balance . Preoperative carbohydrate treatment reduces insulin resistance in the first day after surgery . We hypothesised that preoperative oral carbohydrate treatment attenuates insulin resistance and improves whole-body nitrogen balance 3 days after surgery . METHODS Fourteen patients undergoing total hip replacement were double-blindly r and omised to preoperative oral carbohydrate treatment ( 12.5 % , 800 + 400 ml , n = 8) or placebo ( n = 6 ) . Glucose kinetics ( 6,6-D2-glucose ) , substrate utilisation ( indirect calorimetry ) and insulin sensitivity ( hyperinsulinaemic-euglycaemic clamp ) were measured preoperatively and on the third day after surgery . Nitrogen losses were monitored for 3 days after surgery . Values are mean ( SEM ) . Analysis of variance ( ANOVA ) statistics were used . RESULTS Endogenous glucose release during insulin infusion increased after surgery in the placebo group . Preoperative carbohydrate treatment , as compared to placebo , significantly attenuated postoperative endogenous glucose release ( 0.69 ( 0.07 ) vs. 1.21 (0.13)mg kg(-1 ) x min(-1 ) , P < 0.01 ) , while whole-body glucose disposal and nitrogen balance were similar between groups . CONCLUSIONS While insulin resistance in the first day after surgery has previously been characterised by reduced glucose disposal , enhanced endogenous glucose release was the main component of postoperative insulin resistance on the third postoperative day . Preoperative carbohydrate treatment attenuated endogenous glucose release on the third postoperative day
Intake of a carbohydrate-containing fluid is reported to improve insulin-like growth factor levels , reduce hunger , nausea , and length of stay , and attenuate the decrease in whole-body insulin sensitivity and endogenous glucose release .
Amino acid supplementation is reported to reduce muscle atrophy and accelerate return of functional mobility .
There is limited evidence for nutritional supplementation in THR and TKR pathways ; however , the low risk profile and potential benefits to adjunctive treatment methods , such as exercise programs , suggest nutritional supplements may have a role .
Optimizing nutritional status pre-operatively may help manage the surgical stress response , with a particular benefit for undernourished , frail , or elderly individuals
Nutritional supplements can influence outcomes for individuals undergoing major surgery , particularly in older persons whose functional reserve is limited .
Accelerating recovery from total hip replacement ( THR ) and total knee replacement ( TKR ) may offer significant benefits .
Therefore , we explored the role of nutritional supplements in improving recovery following THR and TKR .