Tackling Perisurgical Hyperglycemia Complications with a Simple Solution

By Fatin Chowdhury ‘19

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Figure 1. A maltodextrin/citrulline solution was ingested by certain patients in the study, before surgery.

As major surgery techniques have been developed and refined, better standards of practice before, during, and after surgery have also been established. Researchers in a recent study led by Dr. Barrett A. Kielhorn explored how the ingestion of a small amount of maltodextrin and citrulline solution before surgery would impact patients after colectomy or enterectomy surgery. This change was administered as part of an Enhanced Recovery Program (ERP) and was analyzed using retrospective analysis of glycemic levels in patients before and after surgery.

The researchers examined the surgery-related conditions of 83 patients undergoing non-diabetic colectomy and enterectomy surgeries between January 2016 and March 2017. The patients were categorized into a simple carbohydrate-using (SIM) group and a complex carbohydrate-using (COM) group. 64 ounces of a sports drink were mixed with 238 grams of polyethylene powder, with three doses of neomycin and 500 grams of metronidazole being consequently used for all patients. The SIM group drank a sports drink mixed with complex carbohydrates and simple carbohydrate, while the COM group drank three doses of complex carbohydrate solution prepared in ten ounces. Blood glucose was measured preoperatively and postoperatively. Data was analyzed using statistical analysis, with quantitative variables undergoing linear regression and nominal variables being subject to logarithmic regression.

The researchers found that the COM solution significantly decreased the prevalence of hyperglycemic concerns.  The glycemic variation of patients was lower when preoperative complex carbohydrate loading was administered in small dosages, as insulin resistance and hyperglycemia were decreased. The researchers acknowledged that there were limitations, such as the possibility of selection bias with the study being retrospective in nature. However, this study suggested the need for scientists to analyze and evaluate more effective hyperglycemia treatments.

 

References:

  1. B. A. Kielhorn, et al., The benefits of a low dose complex carbohydrate/citrulline electrolyte solution for preoperative carbohydrate loading: focus on glycemic variability. American Journal of Surgery 215, 373-376 (2018). doi: 10.1016/j.amjsurg.2017.10.029.
  2. Image retrieved from: https://unsplash.com/photos/4YeWeO12hms
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