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Enhanced recovery after surgery protocols aim to optimize perioperative care and improve surgical outcomes. Preoperative carbohydrate loading has demonstrated benefits in reducing insulin resistance and improving patient outcomes. While non-diabetic patients benefit from this approach, its efficacy in diabetic type 2 patients undergoing CABG remains less understood. This study aims to address this gab by evaluating the physiological and clinical outcomes for carbohydrate loading in this specific population.
A randomized controlled trial comparing diabetic type 2 patients receiving carbohydrate loading with those undergoing traditional fasting protocols. Patients will be randomized to two groups; group (a) patients will have carbohydrate loading 2 hours before the surgery (400 ml of 12.5 maltodextrin and 400 ml of over-the-counter fruit-based lemonade), while group (b) patients (control group) will have standard fasting protocol 8 hours before surgery.
Aims of the study:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention arm | Active Comparator | Patients who will have carbohydrate loading 2 hours before the surgery (400 ml of 12.5 maltodextrin and 400 ml of over-the-counter fruit-based lemonade) |
|
| Control arm | No Intervention | Patients who will have standard fasting protocol 8 hours before surgery |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Carbohydrate loading before surgery | Dietary Supplement | Carbohydrate loading 2 hours before the surgery (400 ml of 12.5 maltodextrin and 400 ml of over-the-counter fruit-based lemonade) |
| Measure | Description | Time Frame |
|---|---|---|
| Short Insulin Tolerance Test (KITT) | Short Insulin Tolerance Test (KITT) will test changes in insulin tolerance postoperatively | Preoperatively and up to 72 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| CRP levels | C-Reactive Protein levels in the blood | Preoperatively and up to 72 hours postoperatively |
| Arterial blood gases | Changes in arterial blood gases |
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Inclusion Criteria:
All diabetic type 2 patients undergoing isolated on-pump coronary artery bypass surgery.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mohammad B Izzat, FRCS(CTh) | Contact | +963943240820 | mbizzat@gmail.com | |
| Mohammad S Sioufi, MD | Contact | +963967788163 | m.s.sioufi@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Mohammad B Izzat, FRCS(CTh) | Damascus University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Damascus University Cardiac Surgery Hospital | Recruiting | Damascus | Mazzeh | Syria |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22235107 | Background | Dock-Nascimento DB, de Aguilar-Nascimento JE, Magalhaes Faria MS, Caporossi C, Slhessarenko N, Waitzberg DL. Evaluation of the effects of a preoperative 2-hour fast with maltodextrine and glutamine on insulin resistance, acute-phase response, nitrogen balance, and serum glutathione after laparoscopic cholecystectomy: a controlled randomized trial. JPEN J Parenter Enteral Nutr. 2012 Jan;36(1):43-52. doi: 10.1177/0148607111422719. | |
| 21255977 |
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| ID | Type | URL | Comment |
|---|---|---|---|
| PhD2-2025 | Study Protocol | View IPD |
All IPD will be uploaded on a data sharing platform
December 31, 2026, and will be available permanently
IPD will be open to all through a data sharing platform
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| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| Preoperatively and up to 72 hours postoperatively |
| Operative time | Total operative time, skin-to-skin | Intraoperatively, skin-to-skin |
| CPB duration | Total time spend using cardiopulmonary bypass perfusion | Intraoperatively, using extracorporeal circulation |
| Blood loss | Blood loss and blood product usage | Intraoperatively and up to 72 hours postoperatively |
| Number of grafts performed | Number of grafts performed during the operation | Intraoperatively, skin-to-skin |
| Use of inotrops | Use of inotrops to support the cardiac output | Intraoperatively and up to 72 hours postoperatively |
| Complications | All perioperative complications | Intraoperatively and up to 72 hours postoperatively |
| Background |
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| 28385477 | Background | Weimann A, Braga M, Carli F, Higashiguchi T, Hubner M, Klek S, Laviano A, Ljungqvist O, Lobo DN, Martindale R, Waitzberg DL, Bischoff SC, Singer P. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017 Jun;36(3):623-650. doi: 10.1016/j.clnu.2017.02.013. Epub 2017 Mar 7. |
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