Preoperative oral carbohydrate nutrition: an update

Insulin resistance is a central feature of the metabolic response after elective surgery as well as other trauma, and has been shown to be a predictor of the length of stay after surgery. Carbohydrate treatment instead of overnight fasting before surgery has been shown to reduce postoperative insulin resistance and to reduce hospital stay approximately 20% after elective surgery. For potential use as a clinical routine before surgery, a carbohydrate-rich drink was developed. Gastric emptying of a 50 g oral carbohydrate load using this drink is complete within 90 min after intake. Oral carbohydrate loading before surgery has confirmed previous data, using glucose and insulin infusions, that postoperative insulin resistance is reduced compared with overnight fasted patients before surgery, and this is associated with improved well-being before and after surgery.