Preoperative carbohydrate drink intake attenuate insulin resistance. However, carbohydrate loading may compromise blood glucose control in patients with diabetes. There is some evidence that oral carbohydrate loading may be safe in patients with type 2 diabetes. Therefore, the investigators aim to evaluate whether preoperative carbohydrate intake affects insulin resistance and glycemic variability in patients with diabetes. Fifty patients scheduled for total knee arthroplasty will be divided into carbohydrate (n=25) and control (n=25) groups. Randomly selected patients of the carbohydrate group are given 400ml of 12.8 g/100 ml carbohydrate beverage 2-3 hours before their scheduled operation. In contrast, patients in the control group are fasted from water 2 hours before surgery according to standard protocol.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
50
Randomly selected patients of the carbohydrate group are given oral carbohydrate (400ml) 2-3 hours before surgery.
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institue, Yonsei Universiy College of Medicine
Seoul, South Korea
Glycemic variability
\- Coefficient of glucose variability =SD/mean x 100 (%)
Time frame: Before anesthesia
Glycemic variability
\- J index=0.001 x (MBG +SD)2 mg/dL
Time frame: Before anesthesia
Glycemic variability
\- Coefficient of glucose variability =SD/mean x 100 (%)
Time frame: immediately after anesthesia
Glycemic variability
\- J index=0.001 x (MBG +SD)2 mg/dL
Time frame: immediately after anesthesia
Glycemic variability
\- Coefficient of glucose variability =SD/mean x 100 (%)
Time frame: operation end
Glycemic variability
\- J index=0.001 x (MBG +SD)2 mg/dL
Time frame: operation end
Glycemic variability
\- Coefficient of glucose variability =SD/mean x 100 (%)
Time frame: 1 hour after surgery
Glycemic variability
\- J index=0.001 x (MBG +SD)2 mg/dL
Time frame: 1 hour after surgery
Insulin resistance
Insulin resistance index = fasting glucose x fasting insulin/22.5
Time frame: Before anesthesia
Insulin resistance
serum laboratory test: glucagon
Time frame: Before anesthesia
Insulin resistance
serum laboratory test: GLP-1
Time frame: Before anesthesia
Insulin resistance
serum laboratory test: C-peptide
Time frame: Before anesthesia
Insulin resistance
serum laboratory test: free fatty acid
Time frame: Before anesthesia
gastric volume
gastric volume measured by ultrasonography.
Time frame: Before anesthesia
hand grip strength
hand grip strength measured by electronic hand dynamometer
Time frame: Before anesthesia
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