PMID- 24656290
OWN - NLM
STAT- MEDLINE
DCOM- 20151001
LR  - 20150126
IS  - 1532-1983 (Electronic)
IS  - 0261-5614 (Linking)
VI  - 34
IP  - 1
DP  - 2015 Feb
TI  - Single-dose carbohydrate treatment in the immediate preoperative phase diminishes 
      development of postoperative peripheral insulin resistance.
PG  - 156-64
LID - S0261-5614(14)00072-7 [pii]
LID - 10.1016/j.clnu.2014.02.010 [doi]
AB  - BACKGROUND & AIMS: Preoperative oral carbohydrate (CHO) treatment is known to 
      reduce postoperative insulin resistance, but the necessity of a preoperative 
      evening dose is uncertain. We investigated the effect of single-dose CHO 
      treatment two hours before surgery on postoperative insulin sensitivity. METHODS: 
      Thirty two pigs ( approximately  30 kg) were randomized to 4 groups (n = 8) followed by 
      D-[6,6-(2)H2] glucose infusion and hyperinsulinemic-euglycemic step clamping. Two 
      groups received a morning drink of 25 g carbohydrate (CHO/surgery and 
      CHO/control). Animals in the other two groups were fasted overnight 
      (fasting/surgery and fasting/control). Counter-regulatory hormones, free fatty 
      acids (FFA) and liver and muscle glycogen content were measured serially. 
      RESULTS: Glucose infusion rates needed to maintain euglycemia were higher after 
      CHO/surgery than fasting/surgery during low (8.54 +/- 0.82 vs. 6.15 +/- 0.27 
      mg/kg/min, P < 0.05), medium (17.26 +/- 1.08 vs. 14.02 +/- 0.56 mg/kg/min, P < 0.02) 
      and high insulin clamping (19.83 +/- 0.95 vs. 17.16 +/- 0.58 mg/kg/min, P < 0.05). 
      The control groups exhibited identical insulin sensitivity. Compared to their 
      respective controls, insulin-stimulated whole-body glucose disposal was 
      significantly reduced after fasting/surgery (-41%, P < 0.001), but not after 
      CHO/surgery (-16%, P = 0.180). CHO reduced FFA perioperatively (P < 0.05) and 
      during the clamp procedures (P < 0.02), but did not affect hepatic insulin 
      sensitivity, liver and muscle glycogen content or counter-regulatory hormone 
      profiles. A strong negative correlation between peripheral insulin sensitivity 
      and mean cortisol levels was seen in fasted (R = -0.692, P = 0.003), but not in 
      CHO loaded pigs. CONCLUSIONS: Single-dose preoperative CHO treatment is 
      sufficient to reduce postoperative insulin resistance, possibly due to the 
      antilipolytic effects and antagonist properties of preoperative hyperinsulinemia 
      on the suppressant actions of cortisol on carbohydrate oxidation.
CI  - Copyright (c) 2014 Elsevier Ltd and European Society for Clinical Nutrition and 
      Metabolism. All rights reserved.
FAU - Gjessing, Petter Fosse
AU  - Gjessing PF
AD  - Department of Digestive Surgery, University Hospital of North Norway, Tromso, 
      Norway; Laboratory of Surgical Research, Institute of Clinical Medicine, 
      University of Tromso, Tromso, Norway. Electronic address: 
      petter.fosse.gjessing@unn.no.
FAU - Hagve, Martin
AU  - Hagve M
AD  - Laboratory of Surgical Research, Institute of Clinical Medicine, University of 
      Tromso, Tromso, Norway.
FAU - Fuskevag, Ole-Martin
AU  - Fuskevag OM
AD  - Department of Laboratory Medicine, Institute of Medical Biology, University of 
      Tromso, Tromso, Norway.
FAU - Revhaug, Arthur
AU  - Revhaug A
AD  - Department of Digestive Surgery, University Hospital of North Norway, Tromso, 
      Norway; Laboratory of Surgical Research, Institute of Clinical Medicine, 
      University of Tromso, Tromso, Norway.
FAU - Irtun, Oivind
AU  - Irtun O
AD  - Department of Digestive Surgery, University Hospital of North Norway, Tromso, 
      Norway; Laboratory of Surgical Research, Institute of Clinical Medicine, 
      University of Tromso, Tromso, Norway.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140306
PL  - England
TA  - Clin Nutr
JT  - Clinical nutrition (Edinburgh, Scotland)
JID - 8309603
RN  - 0 (Blood Glucose)
RN  - 0 (Dietary Carbohydrates)
RN  - 0 (Fatty Acids, Nonesterified)
RN  - 0 (Insulin)
RN  - 9005-79-2 (Glycogen)
RN  - AR09D82C7G (Deuterium)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Animals
MH  - Blood Glucose/analysis
MH  - Deuterium
MH  - Dietary Carbohydrates/*administration & dosage
MH  - Fasting
MH  - Fatty Acids, Nonesterified/blood
MH  - Glucose/administration & dosage
MH  - Glucose Clamp Technique
MH  - Glycogen/analysis
MH  - Insulin/blood
MH  - *Insulin Resistance
MH  - Liver/chemistry
MH  - Muscles/chemistry
MH  - Postoperative Complications/*prevention & control
MH  - *Preoperative Period
MH  - Swine
OTO - NOTNLM
OT  - Cortisol
OT  - Free fatty acids
OT  - Glucose oxidation
OT  - Postoperative insulin resistance
OT  - Preoperative oral carbohydrate treatment
EDAT- 2014/03/25 06:00
MHDA- 2015/10/02 06:00
CRDT- 2014/03/25 06:00
PHST- 2013/11/14 00:00 [received]
PHST- 2014/01/21 00:00 [revised]
PHST- 2014/02/27 00:00 [accepted]
PHST- 2014/03/25 06:00 [entrez]
PHST- 2014/03/25 06:00 [pubmed]
PHST- 2015/10/02 06:00 [medline]
AID - S0261-5614(14)00072-7 [pii]
AID - 10.1016/j.clnu.2014.02.010 [doi]
PST - ppublish
SO  - Clin Nutr. 2015 Feb;34(1):156-64. doi: 10.1016/j.clnu.2014.02.010. Epub 2014 Mar 
      6.