The benefits of a low dose complex carbohydrate/citrulline electrolyte solution for preoperative carbohydrate loading: Focus on glycemic variability |
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Authors: | Barrett A Kielhorn Anthony J Senagore Theodor Asgeirsson |
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Institution: | 1. Metro Health - University of Michigan Health System, Wyoming, MI, USA;2. Clinical Associate Professor Michigan State University College of Osteopathic Medicine, Department of Osteopathic Surgical Specialties, USA;3. Professor, Vice Chair Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA;4. West Michigan Surgical Specialists LLC, Grand Rapids, MI, USA;5. Clinical Chief, Division of Colorectal Surgery Mercy Health St Mary’s Hospital, Grand Rapids, MI, USA;6. Clinical Assistant Professor Michigan State University College of Osteopathic Medicine, Department of Osteopathic Surgical Specialties, USA;g. Clinical Assistant Professor Michigan State University College of Human Medicine, USA |
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Abstract: | BackgroundPerioperative insulin resistance is associated with significant hyperglycemia-related morbidity in patients undergoing major surgery. We sought to assess the effect of preoperative loading with a low-dose maltodextrin/citrulline solution compared to a commercially available sports drink on glycemic levels in an established colorectal enhanced recovery program.MethodsRetrospective analysis was undertaken of elective non-diabetic colectomies and enterectomies from January 2016–March 2017. Cohorts included simple (SIM) and complex carbohydrate (COM) groups. Statistical analysis was performed with linear and logarithmic regression.Results83 patients were included (42 SIM, 41 COM). SIM group was older (61.7 vs 52.7 p = 0.012) Glycemic variability was less in the COM group (7.6% vs 21.4% P = 0.034). The frequency of hyperglycemia, postoperative complications, and length of stay trended higher in the SIM group.ConclusionsThis retrospective analysis identifies significant improvement in the perioperative glycemic variability with preoperative low dose complex carbohydrate loading compared to simple carbohydrate loading in colorectal surgery patients. |
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Keywords: | Colorectal surgery Enhanced recovery program Carbohydrate loading Perioperative glycemic control |
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