To evaluate the necessity and safety of preoperative oral carbohydrates in enhanced recovery after surgery (ERAS) protocols for\ndiabetes mellitus patients. We searched PubMed, EMBASE, the Cochrane Library, Chinese Biomedical Literature Database, China\nNational Knowledge Infrastructure, and WANFANG databases for articles published through September 2018. We used the\nCochrane risk-of-bias tool to assess the methodological quality of included studies. Literature screening, data extraction, and\nquality evaluation were performed independently by two investigators. Of the 6328 retrieved articles, five eligible randomized\ncontrolled trials were included. Two were from China and three were from Germany, Sweden, and Canada. Preoperative oral\ncarbohydrates may facilitate control of preoperative blood glucose, improve postoperative insulin resistance in diabetes patients,\nand decrease the occurrence of adverse reactions. However, the overall quality of the included studies was low. The available\nevidence shows that preoperative oral carbohydrates are probably beneficial for patients with diabetes mellitus. High-quality, large\nrandomized controlled trials are needed to verify our findings and provide quantitative results.
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