Canelli R, Louca J, Hartman C, Bilotta F. Preoperative carbohydrate load to reduce perioperative glycemic variability and improve surgical outcomes: A scoping review. World J Diabetes 2023; 14(6): 783-794 [PMID: 37383597 DOI: 10.4239/wjd.v14.i6.783]
Corresponding Author of This Article
Robert Canelli, MD, Associate Professor, Department of Anesthesiology, Boston University School of Medicine, Boston Medical Center, 750 Albany Street Suite 2R, Boston, MA 02118, United States. robert.canelli@bmc.org
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jun 15, 2023; 14(6): 783-794 Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.783
Preoperative carbohydrate load to reduce perioperative glycemic variability and improve surgical outcomes: A scoping review
Robert Canelli, Joseph Louca, Ciana Hartman, Federico Bilotta
Robert Canelli, Joseph Louca, Department of Anesthesiology, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, United States
Ciana Hartman, Department of Anesthesiology, Boston Medical Center, Boston, MA 02118, United States
Federico Bilotta, Department of Anesthesiology, Sapienza University of Rome, Rome 00199, Italy
Author contributions: Canelli R, Louca J, Bilotta F, and Hartman C contributed equally to this work; Canelli R and Bilotta F designed the research study; Canelli R and Hartman C performed the research; Canelli R and Louca J analyzed the articles; Canelli R wrote the manuscript; Bilotta F, Louca J, and Hartman C edited the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Robert Canelli, MD, Associate Professor, Department of Anesthesiology, Boston University School of Medicine, Boston Medical Center, 750 Albany Street Suite 2R, Boston, MA 02118, United States. robert.canelli@bmc.org
Received: December 25, 2022 Peer-review started: December 25, 2022 First decision: January 17, 2023 Revised: January 31, 2023 Accepted: April 25, 2023 Article in press: April 25, 2023 Published online: June 15, 2023 Processing time: 171 Days and 17.1 Hours
Core Tip
Core Tip: Preoperative fasting reduces the risk for aspiration perioperatively; however, it may contribute to intraoperative insulin resistance and glycemic variability (GV). High GV is associated with an increased risk for postoperative complications, including mortality. The administration of a preoperative carbohydrate load (PCL) may reduce perioperative GV and lower the risk for postoperative complications. In this scoping review, we establish the clear negative impact of GV in patients with and without diabetes mellitus in a wide range of clinical settings. However, we are unable to determine from the current body of literature whether a PCL reduces GV intraoperatively and improves surgical outcomes. Future efforts to standardize the content and timing of the carbohydrate load are needed, as well as prospective studies that are designed to evaluate the carbohydrate load effect on GV indices.
