Perioperative carbohydrate loading improves comfort without adverse metabolic or neonatal effects in gestational diabetes mellitus.

Preoperative carbohydrate loading has been known to overcome discomfort and complications associated with cesarean section, but there is a scarcity of evidence on its safety and benefits in patients with gestational diabetes mellitus (GDM). In this study, pregnant women with normoglycemia and GDM were recruited and grouped according to their nutritional choice prior to cesarean delivery. Blood samples and clinical data were collected, and maternal comfort scores based on self-reports and neonatal data recorded. Metabolomic profiling was performed to explore underlying metabolic responses. Results showed perioperative carbohydrate loading significantly reduced thirst, hunger, and anxiety compared with fasting controls in both the normal and GDM groups. The two groups showed no significant differences at any time point in terms of glycemic measures, inflammatory markers, or maternal and neonatal outcomes. Metabolomic analysis revealed distinct but partially overlapping alterations in metabolic pathways at 1 h before surgery between the two groups.