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Cited by 187Enhanced Recovery After SurgeryHyperglycemia and glycemic control in critically ill and hospitalized patientsDietary Effects on Health

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Modulating postoperative insulin resistance by preoperative carbohydrate loading

Ljungqvist, Olle·2009·Best Practice & Research Clinical Anaesthesiology
DOI 10.1016/j.bpa.2009.08.004
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Abstract

The concept of preoperative overnight fasting was challenged and proved to have no benefits over allowing patients to drink clear fluids up until 2 h before surgery. This led to changes in the guidelines for preoperative fasting in many countries around the world. This concept has more recently been developed further. Mounting evidence indicates that instead of being operated in the traditional overnight fasted state, undergoing surgery in the carbohydrate-fed state has many clinical benefits. Many of these clinical effects can be related to reduced postoperative insulin resistance by preoperative carbohydrate loading. This article summarises the present understanding of the mechanisms behind the positive clinical effects and gives an overview of the information available regarding the clinical effects of this treatment. Finally, the article summarises the most recently published national guidelines on preoperative fasting routines where preoperative carbohydrates are recommended for use before a major surgery. These are to be considered for all patients allowed to drink clear fluids and undergoing elective surgery.

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Metadata

Authors
Ljungqvist, O.
Affiliations
Karolinska University Hospital (SE)
Corresponding author
Ljungqvist, Olle
ORCID
Ljungqvist, Olle
Venue
Best Practice & Research Clinical Anaesthesiology
Publisher
Elsevier BV
Published
2009-12
Volume
23
Issue
4
Pages
401-409
ISSN
  • 1521-6896 (ISSN-L)
  • 1753-3740
DOI
10.1016/j.bpa.2009.08.004
OpenAlex
W2109704839
Cited by
187
References
2
Citations by year
2026: 5 · 2025: 7 · 2024: 15 · 2023: 12 · 2022: 11 · 2021: 16 · 2020: 11 · 2019: 11 · 2018: 17 · 2017: 13 · 2016: 9 · 2015: 20 · 2014: 11 · 2013: 6 · 2012: 10
FWCI
1.22
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Best practice & research. Clinical anaesthesiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
  • Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
Keywords
preoperative carbohydrate loading, postoperative insulin resistance, preoperative fasting, elective surgery, surgical stress response
MeSH terms
Animals, Carbohydrates, Fasting, Humans, Insulin, Insulin Resistance, Postoperative Complications, Preoperative Care, Practice Guidelines as Topic, Elective Surgical Procedures

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