maltodextrin and Insulin-Resistance

To study the efficacy of the oral administration of maltodextrin and fructose before major abdominal surgery (MAS).. This prospective, multicenter, parallel-controlled, double-blind study included patients aged 45-70 years who underwent elective gastrectomy, colorectal resection, or duodenopancreatectomy. The intervention group (IG) was given 800 mL and 400 mL of a maltodextrin and fructose beverage at 10 h and 2 h before MAS, respectively, and the control group (CG) received water under the same experimental conditions. The primary endpoint was insulin resistance index (IRI), and the secondary endpoints were fasting blood glucose, fasting insulin, insulin secretion index, insulin sensitivity index, intraoperative blood glucose, subjective comfort score, and clinical outcome indicators.. A total of 240 cases were screened, of which 231 cases were randomly divided into two groups: 114 in the IG and 117 in the CG. No time-treatment effect was detected for any endpoint. The IRI and fasting insulin were significantly lower in the IG than CG after MAS (p = 0.02 & P = 0.03). The scores for anxiety, appetite, and nausea were significantly lower in the IG than CG at 1 h before MAS. Compared with baseline, the scores for appetite and nausea decreased in the IG but increased in the CG.. The oral administration of maltodextrin and fructose before MAS can improve preoperative subjective well-being and reduce postoperative insulin resistance without increasing the risk of gastrointestinal discomfort.

Topics: Administration, Oral; Aged; Blood Glucose; Double-Blind Method; Fructose; Humans; Insulin; Insulin Resistance; Middle Aged; Nausea; Polysaccharides; Prospective Studies; Treatment Outcome

There is a general consensus that overconsumption of sugar-sweetened beverages contributes to the prevalence of obesity and related comorbidities such as type 2 diabetes (T2D). Whether a similar relationship exists for no- or low-calorie "diet" drinks is a subject of intensive debate and controversy. Here, we demonstrate that consuming seven sucralose-sweetened beverages with, but not without, a carbohydrate over 10 days decreases insulin sensitivity in healthy human participants, an effect that correlates with reductions in midbrain, insular, and cingulate responses to sweet, but not sour, salty, or savory, taste as assessed with fMRI. Taste perception was unaltered and consuming the carbohydrate alone had no effect. These findings indicate that consumption of sucralose in the presence of a carbohydrate rapidly impairs glucose metabolism and results in longer-term decreases in brain, but not perceptual sensitivity to sweet taste, suggesting dysregulation of gut-brain control of glucose metabolism.

Topics: Adult; Area Under Curve; Brain; Feeding Behavior; Humans; Insulin Resistance; Middle Aged; Polysaccharides; Sucrose; Sugars; Taste; Time Factors; Young Adult

Intake of sugar-sweetened beverages (SSB) may contribute to cardiovascular risk. The aim of this study was to investigate whether functional sugars with low compared to high glycemic index (GI) have beneficial effects on arterial stiffness during a period of low-physical activity. In a controlled cross-over dietary intervention (55% CHO, 30% fat, 15% protein), 13 healthy men (age: 23.7 ± 2.2 years, body mass index: 23.6 ± 1.9 kg/m²) completed 2 × 1 week of low physical activity following 1 week of normal physical activity (2363 ± 900 vs. 11,375 ± 3124 steps/day). During inactive phases participants consumed either low-GI (isomaltulose) or high-GI SSB (maltodextrin-sucrose), providing 20% of energy requirements. Postprandial vasodilatation (augmentation index, AIx), insulin sensitivity (IS) and Glucagon-like-peptide 1 (GLP-1) responses were measured during a meal test before and after SSB-intervention. Compared to maltodextrin-sucrose-SSB, postprandial vasodilatation was prolonged (AIx after 120 min: 9.9% ± 4.3% vs. 11.4% ± 3.7%,

Topics: Adult; Beverages; Cardiovascular Diseases; Cross-Over Studies; Dietary Carbohydrates; Dietary Sucrose; Exercise; Germany; Glucagon-Like Peptide 1; Glucose Intolerance; Glycemic Index; Humans; Insulin Resistance; Isomaltose; Male; Polysaccharides; Postprandial Period; Risk Factors; Sedentary Behavior; Single-Blind Method; Vascular Stiffness; Vasodilation

Prolonged preoperative fasting increases insulin resistance (IR). The authors investigated whether an abbreviated preoperative fast with glutamine (GLN) plus a carbohydrate (CHO)-based beverage would improve the organic response after surgery.. Forty-eight female patients (19-62 years) were randomized to either standard fasting (control group) or to fasting with 1 of 3 different beverages before video-cholecystectomy. Beverages were consumed 8 hours (400 mL; placebo group: water; GLN group: water with 50 g maltodextrine plus 40 g GLN; and CHO group: water with 50 g maltodextrine) and 2 hours (200 mL; placebo: water; GLN: water with 25 g maltodextrine plus 10 g GLN; and CHO: water with 25 g maltodextrine) before anesthesia. Blood samples were collected pre- and postoperatively.. The mean (SEM) postoperative homeostasis model assessment-insulin resistance was greater (P < .05) in control patients (4.3 [1.3]) than in the other groups (placebo, 1.6 [0.3]; CHO, 2.3 [0.4]; and GLN, 1.5 [0.1]). Glutathione was significantly higher (P < .01) in the GLN group than in both CHO and control groups. Interleukin-6 increased in all groups except the GLN group. The C-reactive protein/albumin ratio was higher (P < .05) in controls than in CHO and GLN groups. The nitrogen balance was less negative in GLN (-2.5 [0.8] gN) than in both placebo (-9.0 [2] gN; P = .001) and control (-6.6 [0.4] gN; P = .04) groups.. Preoperative intake of a GLN-enriched CHO beverage appears to improve IR and antioxidant defenses and decreases the inflammatory response after video-cholecystectomy.

Topics: Acute-Phase Reaction; Adult; Blood Glucose; C-Reactive Protein; Cholecystectomy, Laparoscopic; Fasting; Female; Glutamine; Glutathione; Humans; Insulin Resistance; Interleukin-6; Middle Aged; Nitrogen; Polysaccharides; Postoperative Period; Preoperative Care; Young Adult

To investigate whether the abbreviation of preoperative fasting with a drink containing glutamine and dextrinomaltose improves organic response to surgical trauma.. Thirty-six female patients adult (18-62 years) candidates for elective laparoscopic cholecystectomy were randomly divided into three groups: conventional fasting (fasting group), and two groups receiving two different diets, eight hours (400ml) and two hours before induction of anesthesia (200ml): carbohydrate (CHO) group (12.5% dextrinomaltose) and the glutamine (GLN) group (12.5% dextrinomaltose and 40 and 10g of glutamine, respectively). Blood samples were collected pre and postoperatively.. Twenty-eight patients completed the study. No pulmonary complication occurred. Gastric residual volume was similar between groups (p = 0.95). Postoperatively, all patients from the fasting group had abnormal glucose (> 110mg/dl), this abnormality being of 50% when compared to the CHO group (p = 0.14), and of 22.2% when compared to the GLN group (p = 0.01). All patients who had the fasting period shortened (CHO + GLN) had normal postoperative insulin, contrasting with 66.7% in the fasted group (p = 0.02). The abnormal sensitivity to insulin postoperatively rose from 32.1% to 46.4% of cases (p = 0.24), and it occurred in only 11.1% of patients in GLN group when compared to 55.5% in the fasting group (p = 0.02).. the abbreviation of preoperative fasting for two hours with dextrinomaltose and glutamine improves insulin sensitivity in patients undergoing elective laparoscopic cholecystectomy.

Topics: Adolescent; Adult; Double-Blind Method; Female; Glutamine; Humans; Insulin Resistance; Middle Aged; Polysaccharides; Preoperative Care; Prospective Studies; Time Factors; Young Adult

Studies showing the improvement of insulin sensitivity by reducing the term of preoperative fasting are mostly done in patients undergoing major operations. More information about the role of shortened preoperative fasting in perioperative metabolism is needed for such elective minor/moderate abdominal procedures as laparoscopic cholecystectomy. We investigated the influence of a carbohydrate-rich drink given 2 h before laparoscopic cholecystectomy on insulin resistance and the metabolic response to trauma.. A group of 21 female candidates (18-65 years old) for elective laparoscopic cholecystectomy were randomized to either an 8 h fasting group (control group: n = 10) or to a group receiving 200 ml of a carbohydrate beverage containing 12.5% (25 g, 50 kcal per 100 ml and approximately 285 mOsm) of maltodextrin 2 h before operation (CHO group: n = 11). Blood samples for various biochemical assays were collected both at induction of anesthesia and after the 10th postoperative hour. Insulin resistance was assessed by the HOMA-IR equation (Insulin (microU/ml) x blood glucose (mg/dl)/405).. There were no postoperative complications. Seventy percent (7/10) of the controls and 27.3% (3/11) of the CHO group experienced at least one episode of vomiting (RR = 2.42, 95% Confidence Interval [CI] = 0.88-6.68; P = 0.08). Biochemical analysis showed that serum glucose (P < 0.01), insulin (P < 0.01), lactate/pyruvate ratio (P = 0.03), and triglycerides (P < 0.01) for the control group were higher than for the CHO group. The value of HOMA-IR was significantly greater (P = 0.03) in the conventionally fasted patients than in the CHO group.. Abbreviation of the period of preoperative fasting and administration of a carbohydrate beverage diminishes insulin resistance and the organic response to trauma.

Topics: Adult; Aged; Algorithms; Blood Glucose; Cholecystectomy, Laparoscopic; Clinical Protocols; Elective Surgical Procedures; Fasting; Female; Humans; Insulin; Insulin Resistance; Middle Aged; Polysaccharides; Postoperative Nausea and Vomiting; Preoperative Care; Time Factors; Treatment Outcome; Video-Assisted Surgery; Young Adult

Preoperative carbohydrate loading is a recommended component of enhanced recovery protocols (ERP's), however the impact on postoperative stress-induced insulin resistance remains poorly studied in both diabetics and non-diabetics.. Using our ERP, a preoperative grape juice group (Grape) was compared to the use of 25 g maltodextrin/3 g citrulline (G.E.D.™, SOF Health, LLC) for carbohydrate loading.. The population included 171 patients (Grape n = 96; GED n = 75). Glycemic variability was significantly worse for the Grape group on POD 0 in both non-diabetic (70% vs 41%; p < 0.05) and diabetic patients (66% vs 34%; p < 0.05). Significantly more Grape patients required postoperative insulin regardless of diabetic status.. Following bariatric surgery, the impact of stress induced hyperglycemia is primarily on POD 0 in non-diabetics whereas the effect extends into POD 1 for diabetics. Preoperative loading with G.E.D.™ versus grape juice is associated with a significantly lower rate of glycemic variation and postoperative insulin requirement, demonstrating that drink composition and treatment process reduces the severity of postoperative stress induced hyperglycemia in bariatric surgery patients.

Topics: Adult; Bariatric Surgery; Beverages; Citrulline; Diabetes Mellitus, Type 2; Diet, Carbohydrate Loading; Enhanced Recovery After Surgery; Female; Fruit and Vegetable Juices; Humans; Hyperglycemia; Insulin Resistance; Male; Middle Aged; Polysaccharides; Postoperative Complications; Preoperative Care; Stress, Physiological