Written by Greg Arnold, DC, CSCS. The 89 non-diabetic subjects, who took a combination of supplements before and after surgery, had significantly improved surgery outcomes that led to better glycemic control and less wound infections compared to those who took no supplements.
For people undergoing major surgery such as heart surgery, a potential complication is insulin resistance 1, which can increase by as much a 8 times after major surgery 2 and can last for as long as 3 weeks after the surgery 3,4. The health dangers of insulin resistance is that it causes a rise in blood sugar 5 which leads to increased inflammation, vulnerability to infection, and problems across multiple organs 6. As a result, finding a way to minimize insulin resistance after major surgery may help improve overall surgery outcomes
Now a new study 7 suggests a supplement combination may help. The study involved 89 non-diabetic subjects (61 men, 28 women) aged 49 to 66 who were scheduled to have heart surgery (coronary artery bypass graft). They were assigned to 1 of 4 four groups:
- Taking the supplement 7 days before and 30 days after surgery (22 subjects)
- Taking the placebo 7 days before and 30 days after surgery (23 subjects)
- Taking the supplement 7 days before and placebo 30 days after surgery (22 subjects)
- Taking the placebo 7 days before and supplement 30 after surgery (22 subjects)
The supplement was composed of 15 grams glutamine, 3 grams L-carnitine, 750 mg vitamin C, 250 mg vitamin E, and 150 micrograms of selenium. Blood samples were drawn 7 days before supplementation and 30 days after surgery.
The researchers noted significant benefits with supplementation both before and after surgery:
| Blood sugar (mg/dL) | HOMA-IR | Insulin (MicroUnits/mL) | HbA1c (%) |
|
|---|---|---|---|---|
| Supplement/ Supplement | 4.4% decrease (99 to 94.71) | No change (2.29 to 2.29) | 9.5% decrease (11 to 9.96) | 6% decrease (6 to 5.64) |
| Placebo/ Placebo | 0.4% increase (101.68 to 102.13) | 33.1% increase (2.08 to 2.77) | 30.5% increase (8.5 to 11.1) | 1.2% decrease (6.12 to 6.05) |
| Supplement/ Placebo | 2.7% increase (93.18 to 95.72) | 18.3% increase (1.80 to 2.13) | 13.1% increase (7.90 to 8.94) | 13.1% increase (7.90 to 8.94) |
| Placebo/ Supplement | 0.3% decrease (92.19 to 92) | 16.1% increase (1.73 to 2.01) | 15.6% increase (7.81 to 9.03) | 4.4% decrease (5.93 to 5.67) |
| p - value | < 0.001 | < 0.001 | < 0.001 | 0.007 |
In addition, supplementation led to significantly lower rates of wound infection after surgery (0 infections in supplement/supplement group, 2 infections in supplement/placebo group (9.09% of subjects), 1 infection in placebo/supplement group (4.54% of subjects), and 6 infections in the placebo/placebo group (26.08% of subjects) (p = 0.025).
When suggesting how this supplement combination elicited these insulin benefits, the researchers pointed to the ability of the supplement contents to improve glucose use by tissues 8, decrease insulin sensitivity 9, and protect tissue due to the as well their high antioxidant content 10. They went on to conclude that “Our new metabolic conditioning supplement, whether given pre- or postoperatively, led to better perioperative glycemic control and decreased postsurgical wound infections in non-diabetic patients.”
Source: Akbarzadeh M. Effects of a New Metabolic Conditioning Supplement on Perioperative Metabolic Stress and Clinical Outcomes: A Randomized, Placebo-Controlled Trial. Iran Red Crescent Med J 2016 Jan 9;18(1):e26207. doi: 10.5812/ircmj.26207. eCollection 2016.
Posted August 5, 2016.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com
References:
- Sato H, Carvalho G, Sato T, Lattermann R, Matsukawa T, Schricker T. The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery. The Journal of clinical endocrinology and metabolism. 2010;95(9):4338-4344.
- Ljungqvist O. Jonathan E. Rhoads lecture 2011: Insulin resistance and enhanced recovery after surgery. JPEN Journal of parenteral and enteral nutrition. 2012;36(4):389-398.
- Awad S, Lobo DN. Metabolic conditioning to attenuate the adverse effects of perioperative fasting and improve patient outcomes. Curr Opin Clin Nutr Metab Care. 2012;15(2):194-200.
- Ljungqvist O. Modulating postoperative insulin resistance by preoperative carbohydrate loading. Best practice & research Clinical anaesthesiology. 2009;23(4):401-409.
- Nygren J. The metabolic effects of fasting and surgery. Best practice & research Clinical anaesthesiology. 2006;20(3):429-438.
- Lipshutz AK, Gropper MA. Perioperative glycemic control: an evidence-based review. Anesthesiology. 2009;110(2):408-421.
- Akbarzadeh M, Eftekhari MH, Shafa M, Alipour S, Hassanzadeh J. Effects of a New Metabolic Conditioning Supplement on Perioperative Metabolic Stress and Clinical Outcomes: A Randomized, Placebo-Controlled Trial. Iranian Red Crescent Medical Journal. 2016;18(1).
- Molfino A, Cascino A, Conte C, Ramaccini C, Rossi Fanelli F, Laviano A. Caloric restriction and L-carnitine administration improves insulin sensitivity in patients with impaired glucose metabolism. JPEN Journal of parenteral and enteral nutrition. 2010;34(3):295-299.
- Baines M, Shenkin A. Use of antioxidants in surgery: a measure to reduce postoperative complications. Curr Opin Clin Nutr Metab Care. 2002;5(6):665-670.
- Milei J, Ferreira R, Grana DR, Boveris A. Oxidative stress and mitochondrial damage in coronary artery bypass graft surgery: effects of antioxidant treatments. Compr Ther. 2001;27(2):108-116.
