Clinical effectiveness and safety of preoperative oral carbohydrate loading in patients with diabetes: A systematic review.

BACKGROUND

The effectiveness and safety of preoperative oral carbohydrate (POC) for people with diabetes remain controversial.

METHODS

We systematically reviewed studies comparing POC to fasting or placebo in elective surgery for diabetic adults, focusing on gastric volume, postoperative complications, hospital stay, and glycemic control.

RESULTS

Fourteen studies (n = 1870 patients) were included. POC did not significantly increase gastric volume or aspiration risk in well-controlled type 2 diabetes. Effects on perioperative glucose control varied. POC improved patient comfort and reduced preoperative hypoglycemia in gestational diabetes. Limited evidence suggested potential benefits in cardiac surgery patients.

CONCLUSION

POC is safe for well-controlled type 2 diabetics, enhancing comfort and reducing preoperative hypoglycemia without increasing aspiration risk. However, its effects on glucose control and postoperative outcomes vary. Personalized approaches are crucial, particularly for poorly controlled diabetes.