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Background: Surgery and fasting may trigger a stress response that causes postoperative hyperglycemia and insulin resistance. Development of insulin resistance is associated with the increase of postoperative morbidity and mortality. Objectives: The aim of this study was to verify whether preoperative oral glucose loading can reduce postoperative insulin resistance in subjects undergoing major surgery, and determined the effect of preoperative oral glucose loading frequency to the degree of insulin resistance. Methods: Forty-five subjects who underwent major oncology surgery were randomly selected with concecutive random sampling method. The subjects were divided into 3 groups and each group consisted of 15 peoples, group one was given oral glucose solution preoperatively at night and early morning, group two the oral glucose was given only in the mornings preoperatively and for the control group were given only mineral water. The blood glucose and insulin level were measured at the morning before surgery and after surgery. The degree of insulin resistance was measured with HOMA-IR model. The difference between the groups was analyzed by LSD test, and data that were not normally distributed was analyzed by Mann Whitney test. Results: The median value of postoperative HOMA-IR in the group one was 0.4 (IQR 0.36), group two (IQR 0.78), then the control group was 1.96 (IQR 1.7) with p value was < 0,001, while the value of the difference in HOMA-IR for group one and group two was significantly different with p-value 0.007. Conclusion: Preoperative oral glucose loading may reduce blood sugar levels and insulin resistance postoperatively compared with subjects who fasted preoperatively, thus giving an oral glucose twice (evening and morning) preoperatively more effective in reducing insulin resistance postoperatively compared with subjects who were given oral glucose just only once in the mornings preoperatively.

Preoperative Oral Glucose Loading Decreasing Insulin Resistance with Homa-Ir Methods in Patient Undergoing Major Oncology Surgery