A Randomized Trial of Carbohydrate Preloading in Patients with Type 2 Diabetes Undergoing General Anesthesia

Objective: The objective of the study was to determine the efficacy and safety of preoperative carbohydrate (CHO) loading among patients with type 2 diabetes (T2D) undergoing low to intermediate risk surgery. Materials and methods: A randomized controlled trial was conducted among 50 T2D patients on oral hypoglycemic drugs selected based on the American Society of Anesthesiologists (ASA) grade 2, posted for low to intermediate risk surgeries. Twenty-five participants were randomly allocated to group A (carbohydrate group) and group B (placebo group). Patient well-being in terms of visual analog scale (VAS) scores for hunger, thirst, and postoperative vomiting was assessed. Mean plasma glucose was the primary outcome, gastric volume and pH and VAS scores were secondary outcomes. Results: Clinical variables such as age, gender, body mass index (BMI), fasting plasma glucose (FPG), random plasma glucose (RPG), glycated hemoglobin (HbA1c), surgical duration, fluids, and opioids ad - ministered were comparable between both groups (p > 0.05).The mean plasma glucose levels in the postoperative period at 0 hour in group A and group B was 19.32 mg/dL and 30.13 mg/dL respectively and the difference was statistically significant (p = 0.008). At 10 hours post -surgery, the mean plasma glucose of group A (20.04 mg/dL) was significantly lower than group B (28.5 mg/dL) (p = 0.035). Secondary outcomes in both groups did not show any significant difference (p > 0.05). Conclusions: The improved glycemic control and insulin resistance was observed in the carbohydrate loading group, with no adverse effects, resulting in improved outcomes among patients with T2D undergoing surgery.