Effect of "preoperative" oral carbohydrate treatment on insulin action--a randomised cross-over unblinded study in healthy subjects.
OBJECTIVE
Preoperative intake of a clear carbohydrate-rich drink reduces insulin resistance after surgery. In this study, we evaluated whether this could be related to increased insulin sensitivity at the onset of surgery. Furthermore, we aimed to establish the optimal dose-regimen.


METHODS
Six healthy volunteers underwent hyperinsulinaemic (0.8 mU/kg/min), normoglycaemic (4.5 mmol/l) clamps and indirect calorimetry on four occasions in a crossover-randomised order; after overnight fasting (CC), after a single evening dose (800 ml) of the drink (LC), after a single morning dose (400 ml, CL) and after intake of the drink in the evening and in the morning before the clamp (LL). Data are presented as mean+/-SD. Statistical analysis was performed using the Student's t-test and ANOVA.


RESULTS
Insulin sensitivity was higher in CL and LL (9.2+/-1.5 and 9.3+/-1.9 mg/kg/min, respectively) compared to CC and LC (6.1+/-1.6 and 6.6+/-1.9 mg/kg/min, P<0.01 vs. CL and LL).


CONCLUSIONS
A carbohydrate-rich drink enhances insulin action 3 h later by approximately 50%. Enhanced insulin action to normal postprandial day-time level at the time of onset of anaesthesia or surgery is likely to, at least partly, explain the effects on postoperative insulin resistance.
Division of Surgery, CLINTEC, Karolinska Institutet, Karolinska University Hospital Huddinge and Centre of Gastrointestinal Disease, Ersta Hospital, Stockholm, Sweden.
Monika
M
Svanfeldt
Anders
A
Thorell
Jonatan
J
Hausel
Mattias
M
Soop
Jonas
J
Nygren
Olle
O
Ljungqvist
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D002153:Calorimetry, Indirect; D018592:Cross-Over Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D008297:Male; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D013997:Time Factors
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin