Ingestion of glutamine and maltodextrin two hours preoperatively improves insulin sensitivity after surgery: a randomized, double blind, controlled trial.
OBJECTIVE
To investigate whether the abbreviation of preoperative fasting with a drink containing glutamine and dextrinomaltose improves organic response to surgical trauma.


METHODS
Thirty-six female patients adult (18-62 years) candidates for elective laparoscopic cholecystectomy were randomly divided into three groups: conventional fasting (fasting group), and two groups receiving two different diets, eight hours (400ml) and two hours before induction of anesthesia (200ml): carbohydrate (CHO) group (12.5% dextrinomaltose) and the glutamine (GLN) group (12.5% dextrinomaltose and 40 and 10g of glutamine, respectively). Blood samples were collected pre and postoperatively.


RESULTS
Twenty-eight patients completed the study. No pulmonary complication occurred. Gastric residual volume was similar between groups (p = 0.95). Postoperatively, all patients from the fasting group had abnormal glucose (> 110mg/dl), this abnormality being of 50% when compared to the CHO group (p = 0.14), and of 22.2% when compared to the GLN group (p = 0.01). All patients who had the fasting period shortened (CHO + GLN) had normal postoperative insulin, contrasting with 66.7% in the fasted group (p = 0.02). The abnormal sensitivity to insulin postoperatively rose from 32.1% to 46.4% of cases (p = 0.24), and it occurred in only 11.1% of patients in GLN group when compared to 55.5% in the fasting group (p = 0.02).


CONCLUSIONS
the abbreviation of preoperative fasting for two hours with dextrinomaltose and glutamine improves insulin sensitivity in patients undergoing elective laparoscopic cholecystectomy.
School of Nutrition, Federal University of Mato Grosso, Cuiabá, Mato Grosso – MT, Brazil. dianadock@hotmail.com
Diana Borges
DB
Dock-Nascimento
Jose Eduardo de
JE
Aguilar-Nascimento
Dan
D
Linetzky Waitzberg
D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005973:Glutamine / Q000627:therapeutic use*; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D011134:Polysaccharides / Q000627:therapeutic use*; D011300:Preoperative Care; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
D011134:Polysaccharides; D005973:Glutamine; C008315:maltodextrin