How to Use G.E.D.
The optimal use of G.E.D. within an enhanced recovery program to reduce the risk of postoperative hyperglycemia is:
- Provide 2 (two) G.E.D. 12-oz. drinks between 7:00 p.m. – 10:30 p.m. the night before surgery.
- Allow access to any additional non-carbohydrate-containing clear liquids until 2 hours before surgery, as per the ASA guidelines.
- Provide a final dose of G.E.D. to be completed by 2 hours prior to surgery.
- Use only lactated ringers IV fluid during surgery and the initial postoperative period until a diet can be restarted postoperatively.
This approach works for both non-diabetics and Type 2 diabetics to reduce the impact of surgical stress induced insulin resistance and the resultant hyperglycemia. G.E.D. also provides support for nitric oxide function by maintaining the ARG/ADMA ratio. Obviously, this approach is not effective for Type 1 diabetics, as they are insulin deficient, not resistant.