Fluid diet - preoperative oral diabetes
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To continue oral fluids for people with diabetes until 2 hours before a procedure to replace or maintain the body’s water balance and leave minimal residue in the stomach.
Characteristics
Only fluids that are rapidly cleared from the stomach. All liquids containing fat, protein, and insoluble fibre are excluded. Carbohydrate containing fluids are also excluded to improve perioperative glycaemic control.
Indications
Preparation of patients with diabetes for procedures involving anaesthesia or sedation. This diet can be used up to 2 hours prior to the procedure. Pre-operative oral fluids can improve postoperative wellbeing and clinical outcomes.
Nutritional adequacy
This diet is inadequate in all nutrients and should not be used for more than 12 hours.
Precautions
Patients may not receive a menu. This diet is not suitable for patients on thickened fluids.
Patients without diabetes should be ordered Fluids - Preoperative Oral.
Some patients with diabetes may require small amounts of carbohydrate-containing oral fluids to correct hypoglycaemia.
This should be determined on a case-by-case basis following local protocols.
Paediatrics
Suitable for use in paediatrics when combined with an age-appropriate diet.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | None | - |
| Sauces, gravies | None | - |
| Starchy vegetables / pasta / rice | None | - |
| Vegetables | None | - |
| Soups | None | - |
| Sandwiches | None | - |
| Salads, dressings | None | - |
| Breads, cereals | None | - |
| Spreads | None | - |
| Hot breakfast choices | None | - |
| Fruit | None | - |
| Yoghurt | None | - |
| Desserts | None | - |
| Milk and cheese | None | - |
| Beverages | Water Diet cordial and lemonade Black tea and coffee | All others, including juice, regular cordial and soft drinks. Beverages containing red, blue or purple colouring (natural or added) Thickened fluids |
| Biscuits | None | - |
| Miscellaneous | Carbohydrate-free commercial rehydration fluids Sweetener | Products containing red, blue or purple colouring (natural or added) Cream, pepper, salt, sugar Commercial nutritional supplements |
References
- Smith, I., Kranke, P., Murat, I., Smith, A., O’Sullivan, G., Søreide, E., Spies, C., and in’t Veld, B. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. European Journal of Anaesthesiology. 2011;28:556–569
- American Society of Anesthesiologists Committee on Standards and Practice Parameters. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report [trunc]. Anesthesiology. 2011 Mar;114(3):495-511.
- Lambert, E., and Carey, S. Practice Guideline Recommendations on Perioperative Fasting: A Systematic Review. Journal of Parenteral and Enteral Nutrition. 9 January 2015.
- Nygren, J., Thorell, A., and Ljungqvist, O. Are there any benefits from minimizing fasting and optimization of nutrition and fluid management for patients undergoing day surgery? Current Opinion in Anaesthesiology. 2007; 20:540–544