Is maltodextrin safe preoperative medication for diabetics undergoing minimally invasive colorectal surgery?

Recent research paper compares the effects of preoperative oral maltodextrin and plain water on blood sugar levels in patients undergoing elective laparoscopic or robotic colorectal surgery. The primary objective was to compare blood sugars at 2 hours of anesthesia, with a subgroup analysis among diabetic patients. Secondary outcomes included blood sugars at different time intervals during surgery, thirst scores before induction, gastric aspirate after intubation, and blood sugars at 8-hour intervals postoperatively for 24 hours. The study included 150 patients, and they were randomly assigned to receive either maltodextrin or plain water. The blood glucose level at 2 hours was significantly lower in the maltodextrin group. Additionally, blood glucose levels during and after surgery were consistently lower in the maltodextrin group. The maltodextrin group also reported lower thirst discomfort scores, and the gastric aspirate volume was lower in this group as well. Among diabetic patients, the maltodextrin group showed significantly lower blood glucose levels at various time points during and after surgery compared to the plain water group, with no incidents of hypoglycemia. The study compared its findings with previous research, noting that few randomized trials have compared the effects of oral carbohydrates in diabetic patients. The study also addressed limitations, such as not measuring gastric volume using ultrasound and not assessing muscle strength for the impact of carbohydrates in preventing muscle breakdown after surgery. In conclusion, the study found that oral maltodextrin administration resulted in lower blood sugars during and after surgery compared to plain water, with consistent results among diabetic patients. The paper suggests that larger prospective studies are needed to further establish the safety and effectiveness of oral maltodextrin in the preoperative setting, including different surgical profiles of patients.

Reference –

Kumar, Lakshmi; Ashok, Amaldev; Sudhakar, Abish1; Sreekumar, Gayathri. Preoperative maltodextrin in minimally invasive colorectal surgery: Is it safe for diabetics? A randomised controlled trial. Indian Journal of Anaesthesia 67(12):p 1084-1089, December 2023. | DOI: 10.4103/ija.ija_436_23