The impact of preoperative carbohydrate loading on patients with type II diabetes in an enhanced recovery after surgery protocol

Talutis, Stephanie D.; Lee, Su Yeon; Cheng, Daniel; Rosenkranz, Pamela; Alexanian, Sara M.; McAneny, David

doi:10.1016/j.amjsurg.2020.03.032

Cited by 32 publications

(23 citation statements)

References 11 publications

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“…The preoperative oral carbohydrate load versus placebo in major elective abdominal surgery study comparing preoperative oral intake of 800 mL of water containing 100 g of maltodextrin with that of 800 mL of water showed lower rates of perioperative hyperglycemia after CHO loading (24.2% vs 57.4%) [39]. The existing evidence also indicates that preoperative CHO loading is safely tolerated by patients with type 2 diabetes and does not increase glucose levels or insulin requirements [40].…”

Section: Hyperglycemiamentioning

confidence: 97%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

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This is the first Enhanced Recovery After Surgery (ERAS) guideline dedicated to standardizing and optimizing perioperative care for women undergoing minimally invasive gynecologic surgery. The guideline was rigorously formulated by an American Association of Gynecologic Laparoscopists Task Force of US and Canadian gynecologic surgeons with special interest and experience in adapting ERAS practices for patients requiring minimally invasive gynecologic surgery. It builds on the 2016 ERAS Society recommendations for perioperative care in gynecologic/oncologic surgery by serving as a more comprehensive reference for minimally invasive endoscopic and vaginal surgery for both benign and malignant gynecologic conditions. For example, the section on preoperative optimization provides more specific recommendations derived from the ambulatory surgery and anesthesia literature for the management of anemia, hyperglycemia, and obstructive sleep apnea. Recommendations pertaining to multimodal analgesia account for the recent Food and Drug Administration warnings about respiratory depression from gabapentinoids. The guideline focuses on workflows important to high-value care in minimally invasive surgery, such as same-day discharge, and tackles controversial issues in minimally invasive surgery, such as thromboprophylaxis. In these ways, the guideline supports the American Association of Gynecologic Laparoscopists and our collective mission to elevate the quality and safety of healthcare for women through excellence in clinical practice.

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Section: Hyperglycemiamentioning

confidence: 97%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

View full text Add to dashboard Cite

show abstract

“…Studies have shown that traditional preoperative fasting places patients in a catabolic state, thereby increasing their risk of adverse effects related to the surgery. Preoperative CCD use mitigates this risk by maintaining patients in an anabolic state, allowing for better glycemic control and muscle preservation (Pogatschnik & Steiger, 2015 ; Ackerman et al, 2020 ; Talutis et al, 2020 ; Tall & Nygren, 2020 ). Neither the ERAS Society USA, the American Society for Enhanced Recovery (ASER), or the American Diabetes Association have promulgated specific guidelines on the use of preoperative CCDs.…”

Section: Discussionmentioning

confidence: 99%

“…In most ERAS programs, preoperative carbohydrate-containing drinks (CCD) are a common component. CCDs have been shown to improve the endocrine and metabolic response to surgical stress as well as reduce pre-operative discomfort, e.g., thirst, hunger, anxiety (Pogatschnik & Steiger, 2015 ; Ackerman et al, 2020 ; Hausel et al, 2001 ; Gustafsson et al, 2008 ; Talutis et al, 2020 ; Tall & Nygren, 2020 ; Loodin & Hommel, 2020 ; Çakar et al, 2017 ). Preoperative CCDs include simple carbohydrates, e.g., apple juice, or complex carbohydrates, e.g., maltodextrin, for which there are multiple commercial preparations.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, if surgery occurs, the dysglycemia could be detrimental (American Society of Anesthesiologists Committee, 2011 ). Alternatively, it would be unfortunate if CCDs are withheld from patients with diabetes in order to avoid hyperglycemia when in fact their use is proven safe and effective, since allowing patients with diabetes to avoid preoperative fasting may be particularly beneficial (Ackerman et al, 2020 ; Gustafsson et al, 2008 ; Talutis et al, 2020 ; Tall & Nygren, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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A U.S. survey of pre-operative carbohydrate-containing beverage use in colorectal enhanced recovery after surgery (ERAS) programs

et al. 2021

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Background Carbohydrate-containing drinks (CCD) are administered preoperatively in most enhanced recovery after surgery (ERAS) programs. It is not known which types of CCDs are used, e.g., simple vs. complex carbohydrate, and if the choice of drink differs in patients with diabetes. Methods A national survey was performed to characterize the use of preoperative CCDs within the context of adult colorectal ERAS programs. The survey had questions regarding the use of preoperative CCDs, the types of beverages used, and the timing of beverage administration. The survey was administered electronically to members of the American Society for Enhanced Recovery (ASER) and manually to participants at the 2018 Perioperative Quality and Enhanced Recovery Conference in San Francisco, CA. Results Responses were received from 78 unique hospitals with a colorectal ERAS program of which 68 (87.2%) reported administering a preoperative drink. Of these, 98.5%, 80.9%, and 60.3% of hospitals administered a beverage to patients without diabetes, patients with diabetes not taking insulin, and patients with diabetes taking insulin, respectively. Surprisingly, one third of programs that administered a beverage to patients with diabetes used a simple carbohydrate drink. Conclusions This survey finds a high use of CHO-containing beverages in colorectal ERAS programs. More than half of all programs administer a CHO-containing beverage to patients with diabetes, and surprisingly, there is significant use of simple carbohydrate beverages in patients with diabetes receiving insulin.

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“…Effects of preoperative carbohydrate loading on the clinical outcomes and prognosis were unidenti ed 31,32 , Smith and the colleagues reviewed all the clinical studies and no positive result was found about the relationship between preoperative carbohydrate and postoperative complication 33 . In addition, the safety of carbohydrate use in patients with diabetes remained uncertain [34][35][36] . Furthermore, our previous study found that the composition proportion of carbohydrate could in uence tumor growth and malignance in mice 37 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Predicted Model of Surgical Patients With Enhanced Recovery After Surgery (ERAS): A Multicenter Prospective Clinical Study

Ren¹,

Lv²,

Min³

et al. 2021

Preprint

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Enhanced recovery after surgery (ERAS) has been accepted widely in the whole world. However, clinical effects of ERAS in China have not been systematically reported, and it is still unclear whether there is key component with the present ERAS program to secure enhanced recovery. Patients who were undergoing operations with ERAS program were included. All the perioperative information were collected via a website and a nomogram to predict postoperative complication was conducted. 950 subjects from 59 hospitals were included in this study. Illness of cardiovascular (22.6%) and endocrine system (11.1%) were the top two coexisted diseases preoperatively. The recovery time of ability of drinking water after surgery was 6 (4-8) h, and almost half of patients could do active exercises in bed within 6 h postoperatively. The overall incidence of complications within 1 month postoperatively was 11.1%. Preoperative creatinine and bilirubin, intraoperative maximum systolic blood pressure and NRS scores at rest at postoperative 3 days were independent risk factors for complications within 1 month postoperatively. However, minimally invasive surgery was associated with a decrease probability of the complications. This study firstly indicates preoperative hepatorenal function, intraoperative systolic blood pressure, minimally invasive surgery and postoperative pain control can independently influence the prognosis of surgical patients.

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The impact of preoperative carbohydrate loading on patients with type II diabetes in an enhanced recovery after surgery protocol

Cited by 32 publications

References 11 publications

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

A U.S. survey of pre-operative carbohydrate-containing beverage use in colorectal enhanced recovery after surgery (ERAS) programs

Clinical Outcomes and Predicted Model of Surgical Patients With Enhanced Recovery After Surgery (ERAS): A Multicenter Prospective Clinical Study

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The impact of preoperative carbohydrate loading on patients with type II diabetes in an enhanced recovery after surgery protocol

Cited by 32 publications

References 11 publications

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

A U.S. survey of pre-operative carbohydrate-containing beverage use in colorectal enhanced recovery after surgery (ERAS) programs

Clinical Outcomes and Predicted Model of Surgical Patients With Enhanced Recovery After Surgery&nbsp;(ERAS): A Multicenter Prospective Clinical Study

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Product

Resources

About

Clinical Outcomes and Predicted Model of Surgical Patients With Enhanced Recovery After Surgery (ERAS): A Multicenter Prospective Clinical Study