The Use of a Pre‐operative Carbohydrate Drink in Patients with Diabetes Mellitus: A Prospective, Non‐inferiority, Cohort Study
Bibliographic record
Abstract
Abstract Background Pre‐operative fasting leads to insulin resistance and increased metabolic stress in non‐diabetic patients. Consumption of a carbohydrate drink may alleviate these deleterious effects. Patients with diabetes mellitus represent over 15% of the surgical population, yet concerns over hyperglycemia and aspiration have excluded patients with diabetes mellitus from studies assessing the utility of pre‐operative carbohydrate drinks. Objective To assess for a clinically significant increase in pre‐operative blood glucose concentration (defined as >2 mmol/L) in patients with diabetes consuming a pre‐operative carbohydrate drink. Methods A prospective observational non‐inferiority cohort study of 106 subjects with diabetes mellitus was undertaken to assess the effect of consuming a pre‐operative carbohydrate drink in surgical patients. All patients with diabetes mellitus undergoing surgery (including but not limited to cardiac, neurologic, urologic, and general surgical procedures) were enrolled. Subjects were instructed to consume two carbohydrate‐rich drinks, one before sleeping the evening prior to surgery and another on the day of surgery. Results In total, 43% of subjects were fully compliant with the pre‐operative carbohydrate drink regimen. There were no significant differences between the fully compliant and non‐compliant subjects with respect to baseline characteristics. Consumption of a pre‐operative carbohydrate drink was determined to be non‐inferior to fasting in terms of pre‐operative blood glucose concentration (absolute difference 0.23 mmol/L, 95% CI: −1.00 to 1.45 mmol/L, pnon‐inferiority < 0.01). Neither group was found to be superior in terms of pre‐operative blood glucose concentration, hyperglycemia, or length of stay. Conclusions These findings function as a step toward ensuring pre‐operative carbohydrate drinks are safe in patients with diabetes undergoing surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".