Preoperative Oral Carbohydrate Treatment Minimizes Insulin Resistance

Study Overview
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Brief Summary
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Insulin resistance is a positive protective reaction against surgery .this resistance has some negative consequences for patient health. It is associated with infectious complications. At the same time, Postoperative insulin resistance has been shown to correlate with the length of postoperative stay in hospital. Recently several clinical studies have shown that a carbohydrate-rich drink given 2 h before surgery diminishes postoperative insulin resistance in patient. The aim of our study is to investigate the influence on insulin resistance in patient with diabetes.

Detailed Description
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Insulin resistance is a positive protective reaction against surgery . As a response to surgery, activation of neuroendocrine and inflammation systems occurs as a protective reaction. However, this resistance has some negative consequences for patient health. It is associated with infectious complications. At the same time, Postoperative insulin resistance has been shown to correlate with the length of postoperative stay in hospital. Recently several clinical studies have shown that a carbohydrate-rich drink given 2 h before surgery diminishes postoperative insulin resistance in patient. The aim of our study is to investigate the influence on insulin resistance in patient with diabetes.

Official Title
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Preoperative Oral Carbohydrate Treatment in Diabetes Patients: A Randomized, Double-blind Trial

Conditions
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Insulin Resistance

Intervention / Treatment
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* Dietary Supplement: Preoperative Oral Carbohydrate Drink


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients underwent elective open colorectal resection for colorectal carcinoma and electric orthopedic surgery Exclusion Criteria: Weight loss greater than 10 per cent during the previous 6 months Renal insufficiency (creatinine, > 3 mg/dl; hemodialysis) Hepatic insufficiency (Child-Pugh class, ≥ B) Gastro-oesophageal reflux disease Gastrointestinal obstruction or conditions (including pharmacological treatment) known to affect gastric emptying rate

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Oral carbohydrate<br>fast from midnight the night before surgery, and patients consume 400 ml Preoperative oral carbohydrate preOp®(12.5% carbohydrates, 0.5%kcal/ml, 240 mOsm, pH 4.9, Nutricia Zoetermeer, the Netherlands) 3 hours prior to induction of anesthesia and finished the ingestion within 20 minutes. | Dietary Supplement: Preoperative Oral Carbohydrate Drink<br>* Patients in Oral carbohydrate group consumed 400 ml Preoperative Oral Carbohydrate Drink Nutricia preOp® (12.5% carbohydrates, 0.5kcal/ml, 240 mOsm, pH 4.9, Nutricia Zoetermeer, the Netherlands) 3 hours prior to induction of anesthesia and finished the ingestion within 20 minutes.<br>|
| No Intervention: Fasting<br>fast from midnight the night before surgery, and no preoperative oral carbohydrate loading | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAS | Preoperative general well-beings before assessed with the visual analogue scale (VAS). | 1 day (preoperative period) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HOMA | Preoperative insulin resistance before and immediately after the surgery assessed with the homeostasis model assessment (HOMA) | perioperative period) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Insulin resistance, Diabetes mellitus, Carbohydrate