Enhancing Cesarean Safety for Gestational Diabetes Patients

A recent research investigation examined the safety and practicality of administering a low-concentration carbohydrate solution to patients with gestational diabetes mellitus (GDM) two hours before anesthesia induction for cesarean sections.

The study involved GDM patients scheduled for cesarean section, who were randomly assigned to either an experimental group or a control group. Two hours prior to anesthesia induction, participants in the experimental group consumed 300 mL of a low-concentration carbohydrate solution orally, while those in the control group drank an equivalent amount of warm water.

The study evaluated blood glucose and serum insulin levels at three key time points: 2 hours before anesthesia induction, just before anesthesia induction, and on the morning of the first postoperative day. It also monitored neonatal blood glucose levels at birth and assessed maternal gastrointestinal function and overall well-being during the perioperative period.

The study observed-

• Significantly higher levels of blood glucose and serum insulin right before induction of anesthesia in the experimental group than those in the control group. 
• Four cases of hypoglycemia in the experimental group and 19 cases in the control group right before the induction of anesthesia. 
• 2.3% incidence of neonatal hypoglycemia in the experimental group and 7.1% in the control group with no significance. 
• Significantly different Hunger scores of the participants between the two groups right before the induction of anesthesia. 
• No aspiration, nausea, or vomiting in both group before, during, and after surgery. 
• No significant difference in the time to the first flatus and abdominal distension between the two groups.

This study proves that consuming low-concentration carbohydrate solution is safe and feasible for patients with GDM undergoing elective cesarean section.

Liu N, Jin Y, Wang X, Xiang Z, Zhang L, Feng S. Safety and feasibility of oral carbohydrate consumption before cesarean delivery on patients with gestational diabetes mellitus: A parallel, randomized controlled trial. Journal of Obstetrics and Gynaecology Research. 2021;47(4):1272-1280. https://doi.org/10.1111/jog.14653