The pre-operation of the cesarean of the patients with the load of carbohydrate effect on the insulin resistance and the blood glucose level of the newborn

Abstract

Objective To evaluate the comfort satisfaction and the insulin resistance of patients with cesarean section and the effects of the postoperative blood sugar on the newborns during the operation. Methods Forty patients who were got elective C-section were selected and divided randomly into two groups(n=20): oral carbohydrate group(CHO group), oral placebo group(P group). Both groups used epidural anesthesia, and a routine preoperative fasting 300 ml carbohydrate drinks(it contains 14.1 g of carbohydrates per 100 ml of drink) was administrated orally 2 h before anesthesia in oral CHO group. Patients in oral placebo group were given an equal amount distilled water instead of carbohydrate. The levels of blood glucose, plasma insulin and glucagons were tested after 2 h and after fetus delivery. According to levels of blood glucose and insulin, homeostasis model assessment(HOME) was applied to calculate the index of insulin resistance(HOMA-IR) and insulin sensitivity index(HOMA-ISI). After fetus delivery, neonates blood glucose was tested immediately. Meanwhile, the subjective comfort satisfaction of the two groups patients were also tested. Results After fetus delivery, blood glucose levels of two groups were significantly elevated than the levels of 2 h after loading(P<0.05). But there is no difference of blood glucose levels between two groups. Compare with levels of 2 h after loading, patients in P group had higher insulin levels, elevated HOMA-IR levels and lower HOME-ISI levels than levels of patients in CHO group (P<0.05). Patients in P group had higher glucagon levels that patients in CHO group. Patients in CHO group have less sense of hunger. Patients of two groups have no difference on sense of vomiting. The neonates blood glucose levels in the CHO group was higher than those in P group(P<0.05). Apgar scores of newborns in two groups are not different. Conclusions C-section preoperative oral intake of carbohydrate can safely reduce the insulin resistance and relieve the feelings of thirst, and help to raise blood glucose levels in newborns. Key words: Csection; Carbohydrate; Insulin resistance; Newborn; Blood glucose