Abstract

COJ Reviews & Research

The Stress Response to Surgery and Oral Carbohydrate Loading of Patients with Diabetes Mellitus: A Case-Based Review

  • Open or CloseMuhammad Abdur Rahman1,2, Kazi Farhana Akhter3,4 and Rajkumar Rajendram5,6*

    1Department of Anaesthesia, Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    2Brighton and Sussex Medical School, University of Brighton, Falmer Campus, Brighton, UK

    3Department of Anaesthesia, Evercare Hospital Dhaka, Bangladesh

    4University of Chester, Exton Park Campus, Chester, UK

    5Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia

    6College of Medicine, King Saud bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia

    *Corresponding author: Rajkumar Rajendram, Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. ORCID: 0000-0001- 7790-4591

Submission: October 11, 2021; Published: December 14, 2021

DOI: 10.31031/COJRR.2021.03.000569

ISSN: 2639-0590
Volume3 Issue4

Abstract

Preoperative oral carbohydrate loading improves outcomes of major elective surgery. However, the preoperative administration of oral carbohydrate loads to patients with diabetes mellitus remains controversial. An illustrative case highlights several issues. Consider, a 63-years-old man with type 2 diabetes and ischaemic heart disease having laparoscopic right hemicolectomy for colon cancer. Oral carbohydrate loading is not administered preoperatively. The postoperative blood glucose control is poor. Preoperative oral carbohydrate reduces insulin resistance. In this context, it is important to determine whether preoperative oral carbohydrate loading may improve postoperative glucose control in patients with insulin resistance. High quality randomized controlled trials are, therefore, urgently required.

Keywords: Preoperative assessment; Diabetes; Oral carbohydrate loading; Stress response; Insulin resistance

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