PMID- 37790019
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231005
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 9
DP  - 2023 Sep
TI  - Effect of Carbohydrate Loading in Diabetic Patients Undergoing Laparoscopic 
      Cholecystectomy: A Randomized Controlled Trial.
PG  - e44570
LID - 10.7759/cureus.44570 [doi]
LID - e44570
AB  - INTRODUCTION: Investigations of preoperative oral carbohydrate (CHO) loading have 
      primarily examined benefits among patients without diabetes. Preoperative 
      CHO-rich beverages in general populations have resulted in reductions in insulin 
      resistance after surgery, protein loss, metabolic derangements, and immune 
      dysfunction. The aim of this study was to assess the effect of CHO loading in 
      diabetic patients undergoing laparoscopic cholecystectomy. METHODS: Diabetic 
      patients controlled on oral hypoglycemic agent were randomly divided into two 
      groups: (1) Group T - this group will be given 50 g of maltodextrin before two 
      hours of surgery; (2) Group C - this group will be kept nil per oral as per 
      standard protocol. Blood sugar, serum insulin, serum cortisol, and insulin 
      requirement were compared in both groups. RESULTS: Blood sugar levels of Group C 
      were found to be significantly higher than that of Group T at six hours and 24 
      hours. In Group T, a rise in baseline serum insulin (8.94 +/- 3.43 mIU/l) was 
      observed at 24 hours (13.23 +/- 5.71 mIU/l). A change of 4.29 +/- 3.00 mIU/l in serum 
      insulin level was observed. The change in baseline serum insulin levels was 
      47.99%. In Group C too, a rise in baseline serum insulin (6.27 +/- 1.74 mIU/l) was 
      observed at 24 hours (18.00 +/- 5.34 mIU/l). A change of 11.73 +/- 4.97 mIU/l in 
      serum insulin level was observed. The change in baseline HOMA-IR (homeostatic 
      model assessment for insulin resistance) levels in Group T was 53.66%. A rise 
      (4.39 +/- 1.63) in baseline HOMA-IR of Group C (1.65 +/- 0.45) was observed at 24 
      hours (6.04 +/- 1.76). The change in baseline HOMA-IR levels in Group C was 
      266.06%. CONCLUSIONS: CHO loading is observed to be beneficial in diabetic 
      patients undergoing laparoscopic cholecystectomy. No adverse effects or an 
      increased risk of aspiration were observed in the intervention group during the 
      study period.
CI  - Copyright (c) 2023, Yadav et al.
FAU - Yadav, Kavita
AU  - Yadav K
AD  - Anesthesiology, King George's Medical University, Lucknow, IND.
FAU - Prakash, Ravi
AU  - Prakash R
AD  - Anesthesiology, King George's Medical University, Lucknow, IND.
FAU - Singh, Gyan Prakash
AU  - Singh GP
AD  - Anesthesiology, King George's Medical University, Lucknow, IND.
FAU - Gautam, Shefali
AU  - Gautam S
AD  - Anesthesiology, King George's Medical University, Lucknow, IND.
FAU - Arshad, Zia
AU  - Arshad Z
AD  - Anesthesiology, King George's Medical University, Lucknow, IND.
FAU - Singh, Brijesh P
AU  - Singh BP
AD  - Anesthesiology, King George's Medical University, Lucknow, IND.
LA  - eng
PT  - Journal Article
DEP - 20230902
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10544875
OTO - NOTNLM
OT  - carbohydrate
OT  - carbohydrate loading
OT  - cortisol
OT  - diabetes mellitus
OT  - homa-ir
OT  - insulin
OT  - laparoscopic cholecystectomy
OT  - vas
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/10/04 06:44
MHDA- 2023/10/04 06:45
PMCR- 2023/09/02
CRDT- 2023/10/04 03:57
PHST- 2023/09/02 00:00 [accepted]
PHST- 2023/10/04 06:45 [medline]
PHST- 2023/10/04 06:44 [pubmed]
PHST- 2023/10/04 03:57 [entrez]
PHST- 2023/09/02 00:00 [pmc-release]
AID - 10.7759/cureus.44570 [doi]
PST - epublish
SO  - Cureus. 2023 Sep 2;15(9):e44570. doi: 10.7759/cureus.44570. eCollection 2023 Sep.