title: Preoperative oral rehydration therapy with 2.5 % carbohydrate beverage alleviates insulin action in volunteers.
abstract: Preoperative carbohydrate loading enhances insulin action by approximately 50 %. In some Japanese hospitals, preoperative oral rehydration therapy is performed for preventing dehydration during surgery. We hypothesized that preoperative oral rehydration therapy with a 2.5 % carbohydrate beverage that is widely used in Japan can enhance insulin action. Therefore, we investigated the effect of this 2.5 % carbohydrate beverage on insulin action in volunteers. Six healthy volunteers participated in this crossover randomized study. The participants were segregated into 2 groups: an oral rehydration therapy with 2.5 % carbohydrate beverage group (group A) and a control group (group B). Subjects in group B were allowed to drink only water from 9 pm the day before the test; conversely, group A fasted from 9 pm onward and drank 500 ml of the beverage containing 2.5 % carbohydrate (OS-1; Otsuka Pharmaceutical Factory, Tokushima, Japan) between 9 and 12 pm and again at 6.30 am. At 8.30 am, a hyperinsulinemic normoglycemic clamp was initiated using an artificial pancreas STG-22 (Nikkiso, Tokyo, Japan). Insulin action was evaluated in both groups using the glucose infusion rate. Blood glucose levels at the initiation of the clamp procedure were similar. However, the glucose infusion rate for group A was significantly higher than that of group B (8.6 ± 1.5 vs. 6.8 ± 2.0 mg/kg/min, p = 0.009). In conclusion, the hyperinsulinemic normoglycemic clamp using an artificial pancreas showed that the administration of a 2.5 % carbohydrate oral rehydration solution for preoperative oral rehydration therapy improves insulin action in volunteers.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kohasu Oko-cho, Nankoku, Kochi, 783-8505, Japan, yatabe@kochi-u.ac.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Yatabe
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
authors.forename: Masataka
authors.initials: M
authors.lastname: Yokoyama
mesh_terms: D000328:Adult; D005260:Female; D005440:Fluid Therapy; D064368:Healthy Volunteers; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D019397:Pancreas, Artificial; D011300:Preoperative Care
references.citation: J Artif Organs. 2011 Sep;14(3):232-7
references.pmid: 21626098
references.citation: Metabolism. 1997 Sep;46(9):1068-73
references.pmid: 9284898
references.citation: Br J Surg. 2010 Mar;97(3):317-27
references.pmid: 20101593
references.citation: Diabetes Care. 2001 Mar;24(3):533-8
references.pmid: 11289481
references.citation: Asia Pac J Clin Nutr. 2013;22(1):48-53
references.pmid: 23353610
references.citation: J Anesth. 2012 Feb;26(1):20-7
references.pmid: 22041970
references.citation: Clin Nutr. 2012 Dec;31(6):817-30
references.pmid: 23079762
references.citation: Anesthesiology. 2009 Feb;110(2):408-21
references.pmid: 19194167
references.citation: Clin Nutr. 2012 Dec;31(6):783-800
references.pmid: 23099039
references.citation: J Clin Endocrinol Metab. 2010 Sep;95(9):4338-44
references.pmid: 20631016
references.citation: JAMA. 2004 Jun 2;291(21):2628-31
references.pmid: 15173155
references.citation: Nutrition. 2010 Nov-Dec;26(11-12):1122-9
references.pmid: 20097532
references.citation: J Clin Endocrinol Metab. 2006 Jan;91(1):290-4
references.pmid: 16234307
references.citation: J Anesth. 2009;23(2):222-9
references.pmid: 19444561
references.citation: Am J Physiol. 1979 Sep;237(3):E214-23
references.pmid: 382871
references.citation: Clin Nutr. 2005 Oct;24(5):815-21
references.pmid: 15979768
references.citation: Ann Surg. 2010 Aug;252(2):247-53
references.pmid: 20622656
references.citation: J Anesth. 2011 Aug;25(4):558-62
references.pmid: 21607766
references.citation: Int J Epidemiol. 2010 Apr;39 Suppl 1:i75-87
references.pmid: 20348131
references.citation: Surg Today. 2012 Jul;42(7):613-24
references.pmid: 22581289