ArticleCureus2026
Preoperative Gastric Ultrasonography in Diabetic Versus Non-diabetic Patients Undergoing Elective Surgery: A Prospective Comparative Observational Study of Gastric Volume and Airway Management Implications.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background Pulmonary aspiration remains a serious perioperative complication associated with considerable morbidity and mortality. Although standard fasting guidelines are intended to minimize aspiration risk, patients with diabetes mellitus may experience delayed gastric emptying despite adequate fasting due to autonomic dysfunction and altered gastric motility. Point-of-care gastric ultrasonography has emerged as a practical bedside tool for evaluating residual gastric contents and may assist in perioperative airway planning. This study aimed to compare fasting gastric volume between diabetic and non-diabetic patients undergoing elective surgery using ultrasonography and to evaluate the distribution of airway management strategies according to preoperative ultrasonographic findings. Methods This prospective comparative observational study was conducted in the Department of Anesthesiology and Intensive Care at a tertiary care teaching hospital between June 2024 and November 2025. A total of 122 adult patients of either sex aged 30-75 years undergoing elective surgery under general anesthesia were enrolled and equally divided into Group C (non-diabetic, n = 61) and Group D (diabetic, n = 61). All patients underwent preoperative gastric ultrasonography after at least eight hours of fasting. Gastric antral measurements were obtained in both supine and right lateral decubitus (RLD) positions. Gastric cross-sectional area (CSA) and estimated gastric volume were calculated using standard formulas. Qualitative gastric grading was performed, and airway management strategies were selected according to ultrasonographic findings. Results Baseline fasting duration was similar between groups (8.6 ± 0.9 h vs 8.8 ± 0.9 h, p = 0.410). In the supine position, diabetic patients demonstrated significantly larger craniocaudal diameter (2.14 ± 0.14 cm vs 1.92 ± 0.18 cm), anteroposterior diameter (1.35 ± 0.08 cm vs 1.01 ± 0.09 cm), and gastric antral CSA (2.27 ± 0.19 cm
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