• Mohanad Baldawi, Nancy Ghaleb, George McKelvey, Yara M Ismaeil, and Wael Saasouh.
• Wayne State University/Detroit Medical Center, Department of Anesthesiology, 3990 John R. Street, Detroit, MI 48201, USA. Electronic address: mohanad.baldawi90@gmail.com.
• J Clin Anesth. 2024 May 1; 93: 111365111365.

Study ObjectiveTo conduct a systematic literature review of the current evidence on the effect of diabetes mellitus on gastric volume observed during a preoperative ultrasound examination. Using the results of this systematic literature review, a meta-analysis was performed to investigate whether there was an association between diabetes mellitus and an increased risk of presenting with a high-risk stomach (gastric volume associated with an increased risk of pulmonary aspiration).DesignReview article and meta-analysis.SettingReview of published literature.PatientsA total of 3366 patients underwent surgery.InterventionGastric ultrasound examination.MeasurementsData for the meta-analysis and literature review were collected from the PubMed/Medline, Embase, Web of Science, and Google Scholar databases of the National Library of Medicine from the date of inception to January 2023. All included studies measured the gastric antral cross-sectional area and/or gastric residual volume in patients with diabetes and those without diabetes. The data utilized in the meta-analysis included all studies that evaluated the incidence of high-risk stomachs based on ultrasonographic measurements of the gastric antral cross-sectional area or gastric residual volume.Main ResultsMost collated studies revealed that diabetes mellitus was associated with increased antral cross-sectional area and gastric residual volume. A meta-analysis of published reports indicated that patients with diabetes have an increased rate of high-risk stomachs.ConclusionsDiabetes mellitus is associated with an increased rate of high-risk stomachs. The authors recommend large prospective trials to ascertain the safety of the current fasting guidelines for patients with diabetes undergoing surgery.Copyright © 2023. Published by Elsevier Inc.

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