As molecular switch to regulate the activity of serine/threonine-specifc kinase, PTK and PI3K signaling pathways act cascades important in mediating insulin's effects on endpoint responses. Defects in the receptor kinase activity and signal transduction in the skeletal muscle have been shown previously as a major contributor to the pathogenesis of insulin-resistant states, such as obesity and type II diabetes. Despite these findings, the mechanism by which preoperative oral carbohydrate beverage consumption exerts the effect that attenuating immediate PIR in patients is still unknown. Defects of insulin signal transduction via PI3K-dependent pathway may be possible involved in the development of PIR, and are highly speculated as the main molecular signaling mechanism.