Preoperative Oral Carbohydrate Drink for Elective Cesarean Delivery and the Effect on Insulin Sensitivity



Status:Enrolling by invitation
Conditions:Neurology, Endocrine
Therapuetic Areas:Endocrinology, Neurology
Healthy:No
Age Range:Any - 50
Updated:2/23/2019
Start Date:February 25, 2019
End Date:April 20, 2020

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Preoperative fasting and surgery can cause metabolic stress and insulin resistance. Oral
carbohydrate loading has been shown to attenuate the development of insulin resistance in the
non-pregnant population undergoing many different types of surgery. Pregnant women have an
increase in insulin resistance and therefore may further benefit from a preoperative
carbohydrate load prior to cesarean delivery. Although woman in the UK receive a carbohydrate
drink prior to elective cesarean delivery, the metabolic effects of these drinks on the
mother and neonate have not been evaluated.


Inclusion:

- ASA physical status II-III women presenting for scheduled, elective cesarean delivery
under neuraxial anesthesia

- Singleton gestation at term (37-42 weeks)

- Ages 18-50

Exclusion:

- Preexisting diabetes (Gestational diabetes, Type I DM, Type II DM)

- Taking insulin-sensitizing or other medications known to influence glucose or fatty
acid metabolism.

- Kidney, heart, or liver disease. Severe lipid disorders.

- History of bariatric surgery

- Pre-pregnancy BMI >40

- Prolonged period of time (>4 hours) between ingestion of carbohydrate drink and
surgery

- Four or more repeat cesarean sections
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