Simple Versus Complex Preoperative Carbohydrate Drink to Preserve Perioperative Insulin Sensitivity in Laparoscopic Colectomy
Bibliographic record
Abstract
In Brief Introduction: Administration of a preoperative containing complex carbohydrate (CHO) preserves insulin sensitivity after traditional colorectal surgery compared with water or fasting; however, its benefits compared with simple CHO drinks have not been investigated. This randomized controlled trial estimated the extent to which a preoperative simple CHO drink preserves insulin sensitivity, compared with a complex CHO drink. Methods: This randomized trial involved 30 nondiabetic adult patients undergoing laparoscopic colon resection. Perioperative care followed an established Enhanced Recovery Pathway (ERP). Patients were randomized 1:1 to receive either a simple CHO drink (400 mL containing 50 gr of fructose) or a complex CHO drink (400 mL containing 40 gr of maltodextrin and 10 gr of fructose) 2 hours before surgery. The primary outcome was intraoperative insulin sensitivity assessed by peripheral glucose uptake (M value) during hyperinsulinemic euglycemic clamp. Secondary outcomes included postoperative hepatic insulin resistance assessed by Homeostatic model assessment (HOMA2-IR), fasting blood glucose (FBG), and C-reactive protein (CRP) at baseline and postoperative day (POD 1–3), 30-day complications, and hospital length of stay (LOS). Results: Intraoperative insulin sensitivity was maintained in both groups with no difference after ingestion of the simple or complex CHO drink [mean (SD) M value 8.3 (3.3) vs 8.8 (3.8) mg/kg/min, P = 0.7). Postoperative insulin sensitivity was maintained, with no differences in hepatic insulin resistance (HOMA2-IR) or fasting blood glucose on POD 1 to 3. There were no differences in complications or LOS. Conclusions: After laparoscopic colectomy in an ERP, perioperative insulin sensitivity was maintained and not further impacted by the preoperative ingestion of a complex or simple CHO drink.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".