Abstract
BackgroundMany individuals undergoing surgery involving general anesthesia are asked to fast for a prolonged period to ensure perioperative safety, yet this can initiate stress reactions and insulin resistance, harming postoperative recovery. Such fasting may be particularly problematic for those who have type 2 diabetes. Here we assessed how giving such individuals oral carbohydrates before total knee arthroplasty can affect outcomes. MethodsWe randomized 90 patients who had non-insulin dependent type 2 diabetes mellitus who were scheduled for elective total knee arthroplasty at one medical center between April 2022 and January 2023 to receive oral carbohydrates at 2 or 4 hours before surgery or to receive a carbohydrate-free "placebo" drink at 4 hours before surgery. The three groups were compared in terms of postoperative blood glucose, insulin resistance, β cell activity, postoperative wound complications, and other clinical outcomes. ResultsThe group who received oral carbohydrates at 2 or 4 hours before surgery showed significantly lower insulin resistance than the placebo group (group at 2 hours, 9.0 ± 3.4; group at 4 hours, 15.8 ± 6.9 versus placebo, 30.9 ± 10.5, P < 0.001) and lower β cell activity (207.7 ± 106.7%; group at 4 hours, 243.2 ± 114.9% versus 421.5 ± 209.3%, P < 0.001). Those groups were also significantly less likely than the placebo group to experience preoperative hunger or postoperative hyperglycemia. Among patients who received oral carbohydrates, those who received them 2 hours before surgery showed significantly lower insulin resistance and better glycemic control on postoperative day 1 than those who received carbohydrates 4 hours before surgery. None of the subjects developed intraoperative aspiration or experienced severe postoperative complications. ConclusionOral carbohydrates at 2 to 4 hours before total knee arthroplasty are safe and can significantly alleviate preoperative hunger while mitigating postoperative insulin resistance and improving glycemic control in patients who have non-insulin-dependent type 2 diabetes mellitus.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
