Enhanced recovery after surgery protocols aim to optimize perioperative care and improve surgical outcomes. Preoperative carbohydrate loading has demonstrated benefits in reducing insulin resistance and improving patient outcomes. While non-diabetic patients benefit from this approach, its efficacy in diabetic type 2 patients undergoing CABG remains less understood. This study aims to address this gab by evaluating the physiological and clinical outcomes for carbohydrate loading in this specific population.
A randomized controlled trial comparing diabetic type 2 patients receiving carbohydrate loading with those undergoing traditional fasting protocols. Patients will be randomized to two groups; group (a) patients will have carbohydrate loading 2 hours before the surgery (400 ml of 12.5 maltodextrin and 400 ml of over-the-counter fruit-based lemonade), while group (b) patients (control group) will have standard fasting protocol 8 hours before surgery. Aims of the study: 1. To assess the efficacy of carbohydrate loading in reducing insulin resistance in diabetic type 2 patients undergoing CABG surgeries. 2. To monitor clinical outcomes such as infection rates, ICU stay duration, and need for inotropic and vasoactive drugs. 3. To evaluate changes in inflammatory markers including CRP levels. clinical outcome
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
50
Carbohydrate loading 2 hours before the surgery (400 ml of 12.5 maltodextrin and 400 ml of over-the-counter fruit-based lemonade)
Damascus University Cardiac Surgery Hospital
Damascus, Syria
RECRUITINGShort Insulin Tolerance Test (KITT)
Short Insulin Tolerance Test (KITT) will test changes in insulin tolerance postoperatively
Time frame: Preoperatively and up to 72 hours postoperatively
CRP levels
C-Reactive Protein levels in the blood
Time frame: Preoperatively and up to 72 hours postoperatively
Arterial blood gases
Changes in arterial blood gases
Time frame: Preoperatively and up to 72 hours postoperatively
Operative time
Total operative time, skin-to-skin
Time frame: Intraoperatively, skin-to-skin
CPB duration
Total time spend using cardiopulmonary bypass perfusion
Time frame: Intraoperatively, using extracorporeal circulation
Blood loss
Blood loss and blood product usage
Time frame: Intraoperatively and up to 72 hours postoperatively
Number of grafts performed
Number of grafts performed during the operation
Time frame: Intraoperatively, skin-to-skin
Use of inotrops
Use of inotrops to support the cardiac output
Time frame: Intraoperatively and up to 72 hours postoperatively
Complications
All perioperative complications
Time frame: Intraoperatively and up to 72 hours postoperatively
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