Carbohydrate Loading and Diabetes in Colorectal Surgery
In Individuals With Diabetes Undergoing Elective Colorectal Surgery, Is Carbohydrate Loading Preoperatively Safe? A Pilot Randomized Controlled Trial
The goal of this study is to evaluate the feasibility of conducting a large study that would assess the safety of carbohydrate drinks (i.e. juice) prior to elective colorectal surgery in patients with type 2 diabetes.
Traditionally, prior to surgeries involving a general anesthetic, patients have been told not to eat or drink anything after midnight due to the risk of aspiration. More recent research have shown that it is safe to have clear fluids up to 2 hours before an operation and this is reflected in the current anesthesia clinical guidelines. Moreover, it has been shown that subjecting patients to a state of starvation causes stress on the body that may lead to complications such as poor wound healing, infections, and delayed return to bowel function. A sugar drink before surgery has been shown to be beneficial and can lead to decreased complication rates and decreased length of stay after surgery.
However, it is currently not known if it is safe for patients with type 2 diabetes to have a sugar drink before their surgery since they have trouble processing sugars and a subset of patients with diabetes are at increased risk of aspiration due to delayed stomach emptying.
This feasibility study is designed to answer the question of whether a large scale trial can be conducted examining the benefits of a pre-operative sugar drink in patients with type 2 diabetes.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Alberta
-
Edmonton, Alberta, Canada, T6G 2B7
- University of Alberta Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All adult (>=18 years of age) patients with an established diagnosis of type 2 diabetes mellitus undergoing elective colorectal surgery at the University of Alberta Hospital, the Grey Nuns Hospital, the Royal Alexandra Hospital or the Misericordia Hospital will be eligible. Only patients treated with diet or oral hypoglycemic agents will be included.
Exclusion Criteria:
- Subjects <18 years of age, and those on insulin therapy preoperatively will be excluded.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Standard Care
Standard care for patients with diabetes pre-operatively .
|
|
|
Experimental: Carbohydrate drink
Carbohydrate drink containing 40g of carbohydrate to be consumed three hours prior to surgery
|
Carbohydrate drink containing 40g of carbohydrate to be consumed three hours prior to surgery
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mean difference of preoperative glucose between the two groups
Time Frame: Pre-operative
|
Examined in a non-inferiority fashion with NI margin set as 2mmol/L
|
Pre-operative
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Composite outcome of diabetes-related complications
Time Frame: Within 30 days of surgery or to discharge
|
hypoglycemia, DKA, cancellation of surgery, ketosis or perioperative aspiration
|
Within 30 days of surgery or to discharge
|
|
length of stay
Time Frame: Within 30 days of surgery or to discharge
|
How long the patient stays in hospital after surgery in days
|
Within 30 days of surgery or to discharge
|
|
Surgical site infection
Time Frame: Within 30 days of surgery or to discharge
|
Whether a wound infection is noted in hospital
|
Within 30 days of surgery or to discharge
|
|
Postoperative complications using the Clavien Dindo scale
Time Frame: Within 30 days of surgery or to discharge
|
A composite measure of post-operative complications stratified based on the Clavien Dindo scale from 1-5 with increasing severity from 1 to 5.
|
Within 30 days of surgery or to discharge
|
|
Post-operative serum blood glucose concentration
Time Frame: Within 30 days of surgery or to discharge
|
Serum blood glucose compiled on a daily basis
|
Within 30 days of surgery or to discharge
|
|
Rate of peri-operative insulin use
Time Frame: Within 30 days of surgery or to discharge
|
Whether insulin or an insulin infusion in the peri-operative period is used
|
Within 30 days of surgery or to discharge
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Carbs Drink in Colorectal
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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