Preoperative carbohydrate loading for reducing postoperative insulin resistance based on a network Meta-analysis    TIAN Jin-hui*, LI Lun, TIAN Hong-liang，et al. *Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000，China
Corresponding author ：YANG Ke-hu，E-mail：kehuyangebm2006@126.com
Abstract    Objective    Available preoperative carbohydrate loading for reducing postoperative insulin resistance was inconsistent, so it is necessary to conduct a net-work Meta-analysis to evaluate its effects vs. other preoperative interventions. Methods    China Journal Full-text Database（1994-2011）, Chinese Biomedical Database（1978-2011）, Chinese Scientific Journals Full-text Database（1989-2011）, and CMA Digital Periodicals（1997-2011）were searched to include all available randomized controlled trials about the effects of preoperative carbohydrate loading, fasting overnight, placebo and i.v. glucose on serum glucose and serum insulin at the first day, and the degree of insulin resistance. We used the methods of network Meta-analysis to assess the values of different preoperative interventions on serum insulin with ADDIS software.  Results    Seven trials (612 patients) were included. The results of network Meta-analysis showed that there were not any statistical differences in serum glucose and serum insulin levels at the first day, insulin sensitive index, and insulin resistance index, although the ranking results showed that they might have different effects for different outcomes.  Conclusion    Available evidence can not support that preoperative carbohydrate loading, placebo and i.v. glucose could replace fasting overnight, so further larger, more rigor randomized controlled trials should be conducted.