Lin XQ, Chen YR, Chen X, Cai YP, Lin JX, Xu DM, Zheng XC. Impact of preoperative carbohydrate loading on gastric volume in patients with type 2 diabetes. World J Clin Cases 2022; 10(18): 6082-6090 [PMID: 35949825 DOI: 10.12998/wjcc.v10.i18.6082]
Corresponding Author of This Article
Xiao-Chun Zheng, MD, Professor, Department of Anesthesiology, Shenli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Fuzhou 350001, Fujian Province, China. zhengxiaochun2021@163.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Randomized Clinical Trial
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Lin XQ, Chen YR, Chen X, Cai YP, Lin JX, Xu DM, Zheng XC. Impact of preoperative carbohydrate loading on gastric volume in patients with type 2 diabetes. World J Clin Cases 2022; 10(18): 6082-6090 [PMID: 35949825 DOI: 10.12998/wjcc.v10.i18.6082]
Xin-Qiang Lin, Department of Anesthesiology, Affiliated Hospital of Putian College, Putian Maternity and Child Care Hospital, Putian 351100, Fujian Province, China
Yu-Ren Chen, Xiao Chen, Yu-Ping Cai, Jian-Xin Lin, De-Ming Xu, Department of Anesthesiology, Affiliated Hospital of Putian College, Putian 351100, Fujian Province, China
Xiao-Chun Zheng, Department of Anesthesiology, Shenli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
Author contributions: All authors contributed to the study conception and design; Zheng XC designed the study; Material preparation, data collection and analysis were performed by Lin XQ, Chen YR and Chen X; Cai YP, Lin JX and Xu DM contributed sample collection and intellectual input; The first draft of the manuscript was written by Lin XQ and all authors commented on previous versions of the manuscript; All authors read and approved the final manuscript; Lin XQ and Chen YR contributed equally to this study.
Supported byNatural Science Foundation of Fujian Province, No. 2019J01587.
Institutional review board statement: The present study was approved by the Ethics Committee of Putian College Affiliated Hospital, No. 201936.
Clinical trial registration statement: This study is registered at the Chinese Clinical trial registry, No. ChiCTR1900028529.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Corresponding author: Xiao-Chun Zheng, MD, Professor, Department of Anesthesiology, Shenli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Fuzhou 350001, Fujian Province, China. zhengxiaochun2021@163.com
Received: December 22, 2021 Peer-review started: December 22, 2021 First decision: February 8, 2022 Revised: March 21, 2022 Accepted: April 21, 2022 Article in press: April 21, 2022 Published online: June 26, 2022 Processing time: 176 Days and 11.4 Hours
ARTICLE HIGHLIGHTS
Research background
More than 10% of the world's population and almost 15% of surgical patients are reported to have type 2 diabetes (T2D). Diabetic patients are prone to delayed gastric emptying due to the risk of reflux, aspiration and hyperglycemia.
Research motivation
Different guidelines for preoperative carbohydrate loading in diabetic patients are still controversial.
Research objectives
This study is conducted to evaluate the safety and feasibility of preoperative carbohydrate loading on gastric volume (GV) before anesthesia induction in T2D patients.
Research methods
Patients with T2D were randomly allocated to 4 groups receiving 0, 100, 200, or 300 mL of carbohydrate loading 2 h before anesthesia induction. Gastric volume per unit weight (GV/W), Perlas grade, changes in blood glucose level, and risk of reflux and aspiration were evaluated before anesthesia induction.
Research results
No significant difference was found in GV/W among the groups before anesthesia induction (P > 0.05). The number of patients with Perlas grade II and GV/W > 1.5 mL/kg did not differ among the groups (P > 0.05). Blood glucose level increased by > 2 mmol/L in patients receiving 300 mL carbohydrate drink, which was significantly higher than that in groups 1 and 2 (P < 0.05).
Research conclusions
Preoperative carbohydrate loading < 300 mL 2 h before anesthesia induction in patients with T2D did not affect GV or increase the risk of reflux and aspiration. Blood glucose levels did not change significantly with preoperative carbohydrate loading of < 200 mL. However, 300 mL carbohydrate loading may increase blood glucose levels in patients with T2D before induction of anesthesia.
Research perspectives
Our study illustrates the safety and recommended volume of preoperative carbohydrate loading in patients with T2D.
