Postoperative infectious morbidity remain the most frequent, threatening and costly event after major surgery. Maintenance of postoperative euglycemia might be a key factor to prevent such complications and given the preliminary data on the positive effect of carbohydrate load on glucose metabolism it might also be valuable in improving outcome. If this treatment will be proved effective on relevant outcome measure such as rate of infections, it might be used routinely and extensively because preoperative carbohydrates administration is cheap, simple and applicable by everyone in any surgical ward.

The aim of the trial is to evaluate if the normalization of blood glucose by means of preoperative oral administration of maltodextrine, in patients candidate to elective major surgery, may be effective in improve surgical morbidity.

Inclusion Criteria:

• patients candidate for elective major (expected duration > 2 hrs) abdominal, urologic, and gynecologic surgery

Exclusion Criteria:

• diagnosis of diabetes mellitus,
• baseline plasma glucose level > 125 mg/dl,
• pancreatic resection,
• ASA score > 3,
• malnutrition (loss of weight greater than 10%),
• emergency surgery,
• documented gastro-esophageal reflux,
• corticosteroid therapy,
• ongoing infection,
• pregnancy,
• age < 18 years,
• denied written informed consent