Pre-operative Carbohydrate Drink to Preserve Peri-operative Insulin Sensitivity

Inclusion criteria

• At least 18 years of age
• Planned laparoscopic partial colon resection for non-metastatic neoplastic or benign disease (including right, transverse, left or sigmoid))
• HbA1c less than or equal to 5.7%
• Not receiving any kind of glucose lowering medication.

Exclusion criteria

• Are already diagnosed with diabetes or pre diabetes (HbA1c > 5.7%)
• Are pre-diabetic receiving glucose lowering intervention (any glucose lowering medication)
• Have renal or liver dysfunction (serum creatinine above 1.4 mg/dL in women and 1.5 mg/dL in men, bilirubin >2.9 mg/dL)
• Will undergo extended resection of adjacent organs
• Non-elective operations
• New stoma created
• Have conditions precluding participation in the ERAS pathway (e.g. dementia, disabling orthopedic and neuromuscular disease, psychosis)
• Have conditions requiring preoperative fasting: documented gastroparesis, patient on metoclopramide and/or domperidone, achalasia, dysphagia (any difficulty with swallowing), or Fluid restriction (e.g. dialysis, pulmonary oedema, congestive heart failure).
• Have cardiac abnormalities, severe end-organ disease such as cardiac failure (New York Heart Association classes III-IV), chronic obstructive pulmonary disease (documented by abnormal pulmonary function test), morbid obesity (BMI >40 kg/m2), anemia (hematocrit < 30 %, hemoglobin <100g/L, albumin < 25mg/dl)
• Have received steroids for longer than 30 days
• Have poor English or French comprehension.