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