Effectiveness and Safety of Preoperative Oral Carbohydrates in Enhanced Recovery after Surgery Protocols for Patients with Diabetes Mellitus: A Systematic Review
Table 1
Characteristics of the studies included in the systemic review.
First author, (reference) year, region
Preoperative oral carbohydrate type, time, and quantity
Oral 400 ml 12.5% carbohydrate beverage 2 hours before surgery
ASA III–IV heart surgery
56
60
64 ± 9 vs 64 ± 10
Preoperative discomfort VAS score, PIR, length of hospital stay, number of deaths during hospital stay
Preoperative discomfort VAS score were all ; PIR was ; length of hospital stay was
No increase in gastric juice volume or other adverse events were observed; one patient in the placebo group died of intestinal cancer in the ward during hospital stay
The peak blood sugar, the time to reach the peak, the time to restore the baseline glucose concentration, and the time of gastric half emptying
The peak blood sugar after beverage intake of diabetic patients vs health population was 13.4 ± 0.5 vs 7.6 ± 0.5 mM, ; the baseline level restore time was 180 vs 120 min, ; the half emptying time of the stomach was 49.8 ± 2.2 vs 58.6 ± 3.7 min,
No hyperglycemia or aspiration occurred, others were not mentioned
Oral 500 ml cranberry cocktail or apple juice 1 hour before bedtime, one night before operation, and 3 hours before operation
Cardiac, neurological, extraurological, and general surgery
46
60
61.8 vs 66.4
Preoperative blood sugar, preoperative incidence of hyperglycemia, length of hospital stay, number of cases of cancelled surgery, incidence of pneumonia after operation, number of deaths in 30 days
The preoperative blood glucose was 8.3 vs 8.1 mmol/L, ; the preoperative incidence of hyperglycemia was 17.4% vs 16.7%, ; the number of cancelled operations was 0; and the hospital stay was 0.48
Incidence of pneumonia after operation was , and no death occurred within 30 days after operation
ASA III-IV, American Society of Anesthesiologists; FBG, fasting blood glucose; NR, not reported; PIR, postoperative insulin resistance; PIRI: postoperative insulin resistance index; VAS, visual analog scale.