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  4. Vol 5, Issue 7, 2023

Clinical Observation of Preoperative Oral-Carbohydrate Combined with Individualized Medication in Patients with Type 2 Diabetes Mellitus

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DOI: 10.23977/medcm.2023.050703 | Downloads: 9 | Views: 374

Author(s)

Shushu Song 1,2, Huihui Wang 2, Kaiming Yuan 3, Jun Li 1,3

Affiliation(s)

1 Wenzhou Medical University, Wenzhou, Zhejiang, China
2 Department of Anesthesiology, Wenzhou Central Hospital, Wenzhou, Zhejiang, China
3 Department of Anesthesiology and Perioperative Medicine, Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China

Corresponding Author

Jun Li

ABSTRACT

To observe the clinical effect of preoperative oral carbohydrate(POC) combined with individualized medication (oral hypoglycemic agents or/and insulin) that has been used steadily in patients with type 2 diabetes mellitus. Patients undergoing elective laparoscopic non-gastrointestinal surgery were studied. Thirty type 2 diabetic patients with good glycemic control were selected as diabetic group (Group D) and 31 non-diabetic patients were recruited as control group(Group C). In both groups, 400mL carbohydrate drink was taken orally 2 hours before anesthesia. Anti-diabetes medication was given individually in the diabetic group(Group D) according to their daily use. Blood glucose was detected and recorded at the time of fasting (T0), 1 hour after POC (T1), before anesthesia(T2), 15min after pneumoperitoneum(T3), 30min after pneumoperitoneum (T4), and in recovery room (T5) for both groups. Ultrasound of gastric antrum was assessed and semi-quantification of gastric contents(Perlas A scale) was performed. Perioperative hunger, nausea, vomiting and postoperative exhaust time were also recorded. There was no statistically significant difference between two groups above in blood glucose at T0 and T5(P> 0.05);at T1,T2,T3 and T4, compared with Group C, patients in Group D had significantly higher blood glucose (P<0.05), but within 250mg/dl(13.9mmol/L). No additional hypoglycemic intervention implemented; no symptoms of discomfort was reported as well. For gastric antrum Perlas A grading before general anesthesia, there was no statistically significant difference in the scores between the two groups (P> 0.05), and no reflux aspiration was observed in both groups. There was no statistically significant difference in perioperative hunger, nausea and vomiting, and postoperative exhaust time between the two groups (P> 0.05). Preoperative oral carbohydrate (POC) can be applied to well glucose-controlled type 2 diabetic patients.

KEYWORDS

Preoperative oral carbohydrate, Type 2 diabetes, Individualized medication, Blood sugar, Perlas a grading

CITE THIS PAPER

Shushu Song, Huihui Wang, Kaiming Yuan, Jun Li, Clinical Observation of Preoperative Oral-Carbohydrate Combined with Individualized Medication in Patients with Type 2 Diabetes Mellitus. MEDS Chinese Medicine (2023) Vol. 5: 17-23. DOI: http://dx.doi.org/10.23977/medcm.2023.050703.

REFERENCES

[1] Wang Tianlong, Huang Yuguang. Promoting the transformation of anesthesiology to perioperative medicine: Interpretation of the Anesthesiology Part of Chinese Expert Consensus and Pathway Management Guide for Accelerated Rehabilitation Surgery (2018 Edition) [J]. Concord Medical Journal, 2018, 9(6): 481-484.
[2] Meng Y, Ming M, Zhao Y Q, et al. Interpretation of Expert Consensus on perioperative blood glucose management in 2020 [J]. Journal of Hebei Medical University, 2022, 43(1): 1-6, 1
[3] Dong Xintong, Tao Mingzhe. Research progress of perioperative blood glucose management in patients with diabetes. Guangzhou Pharmaceutical, 2012, 43(6): 49-52.
[4] American Diabetes Association Professional Practice Committee. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2022[J]. Diabetes Care, 2022, 45(Suppl 1): S244-S253.
[5] Perlas A, Davis L, Khan M, et al. Gastric sonography in the fasted surgical patient: a prospective descriptive study [J]. Anesth Analg, 2011, 113(1): 93-97.
[6] Burch J. Preoperative carbohydrate loading in the enhanced recovery pathway [J]. Br J Nurs, 2016, 25(12): 669-672.
[7] Singh Sm, Liverpool A, Romeiser Jl, et al. A U.S. survey of pre-operative carbohydrate-containing beverage use in colorectal enhanced recovery after surgery (ERAS) programs [J]. Perioper Med (Lond), 2021, 10(1): 19.
[8] Robinson Kn, Cassady Ba, Hegazi Ra, et al. Preoperative carbohydrate loading in surgical patients with type 2 diabetes: Are concerns supported by data?[J]. Clin Nutr ESPEN, 2021, 45: 1-8.
[9] Lee B, Kim Sy, Cho Bw, et al. Preoperative carbohydrate drink intake increases glycemic variability in patients with type 2 diabetes mellitus in total joint arthroplasty: a prospective randomized trial[J]. World J Surg, 2022, 46(4): 791-799.
[10] Li X, Liu L, Liang Xq, et al. Preoperative carbohydrate loading with individualized supplemental insulin in diabetic patients undergoing gastrointestinal surgery: A randomized trial[J]. Int J Surg, 2022, 98: 106215.
[11] Cheisson G, Jacqueminet S, Cosson E, et al. Perioperative management of adult diabetic patients. Review of hyperglycaemia: definitions and pathophysiology [J]. Anaesth Crit Care Pain Med, 2018, 37 Suppl 1: S5-S8.
[12] Ceriello A, Esposito K, Piconi L, et al. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients[J]. Diabetes, 2008, 57(5): 1349-1354.
[13] Cassady Ba, Mcdonald Jd, Yalawar M, et al. Pilot study on the impact of a carbohydrate loading drink on postprandial glycemic responses and gastric emptying in adults with prediabetes and type 2 diabetes mellitus[J]. Nutr Clin Pract, 2023, 38(1): 108-117.
[14] Lin Xq, Chen Yr, Chen X, et al. Impact of preoperative carbohydrate loading on gastric volume in patients with type 2 diabetes [J]. World J Clin Cases, 2022, 10(18): 6082-6090.
[15] Lee S, Sohn Jy, Lee Hj, et al. Effect of pre-operative carbohydrate loading on aspiration risk evaluated with ultrasonography in type 2 diabetes patients: a prospective observational pilot study [J]. Sci Rep, 2022, 12(1): 17521.
[16] Talutis SD, Lee SY, Cheng D, et al. The impact of preoperative carbohydrate loading on patients with type II diabetes in an enhanced recovery after surgery protocol [J]. Am J Surg, 2020, 220(4): 999-1003.

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