Blood Glucose Dynamics in Diabetic Patients Undergoing Elective Surgery: A Descriptive-Analytical Cross-Sectional Investigation
-
Babak Jahangirifard
,
Hamidreza Karbalaei-Musa
,
Mohammad Hossein Hajali
,
Parisa Kianpour
,
Mohammad Afsahi
Abstract
Background: Major surgeries cause metabolic stress and insulin resistance, leading to postoperative hyperglycemia and increased morbidity and mortality in diabetic patients. Therefore, this study aimed to assess blood sugar level changes in diabetic patients undergoing elective surgery and its confounding factors.
Methods: A cross-sectional study compared blood sugar levels (BS) in 100 diabetic patients undergoing elective surgeries. Demographic data, medical history, surgery type, and anesthetic technique were documented. Laboratory assessments included fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1C). Statistical analysis used SPSS software and nonparametric tests.
Results: Postoperative blood sugar levels significantly increased compared to preoperative levels (mean change 11.40 ± 14.356 mg/dL). Age over 60 and general anesthesia were significant factors associated with elevated blood sugar.
Conclusion: This study reveals a significant postoperative increase in blood glucose levels in diabetic patients, particularly those aged over 60 and under general anesthesia.
[1] Thorell A, Nygren J, Ljungqvist O. Insulin resistance: a marker of surgical stress. Curr Opin Clin Nutr Metab Care. 1999; 2(1):69-78.
[2] Pomposelli JJ, Baxter JK, 3rd, Babineau TJ, Pomfret EA, Driscoll DF, Forse RA, Bistrian BR. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. JPEN J Parenter Enteral Nutr. 1998; 22(2):77-81.
[3] Doenst T, Wijeysundera D, Karkouti K, Zechner C, Maganti M, Rao V, Borger MA. Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery. J Thorac Cardiovasc Surg. 2005; 130(4):1144.
[4] Akhtar S, Barash PG, Inzucchi SE. Scientific principles and clinical implications of perioperative glucose regulation and control. Anesth Analg. 2010; 110(2):478-97.
[5] Black PR, Brooks DC, Bessey PQ, Wolfe RR, Wilmore DW. Mechanisms of insulin resistance following injury. Ann Surg. 1982; 196(4):420-35.
[6] Farrokhi F, Smiley D, Umpierrez GE. Glycemic control in non-diabetic critically ill patients. Best Pract Res Clin Endocrinol Metab. 2011; 25(5):813-24.
[7] Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87(3):978-82.
[8] Frisch A, Chandra P, Smiley D, Peng L, Rizzo M, Gatcliffe C, et al. Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care. 2010; 33(8):1783-8.
[9] Kotagal M, Symons RG, Hirsch IB, Umpierrez GE, Dellinger EP, Farrokhi ET, Flum DR. Perioperative hyperglycemia and risk of adverse events among patients with and without diabetes. Ann Surg. 2015; 261(1):97-103.
[10] Griesdale DE, de Souza RJ, van Dam RM, Heyland DK, Cook DJ, Malhotra A, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. Cmaj. 2009; 180(8):821-7.
[11] Wiener RS, Wiener DC, Larson RJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. Jama. 2008; 300(8):933-44.
[12] Polk HC Jr. Renewal of surgical quality and safety initiatives: a multispecialty challenge. Mayo Clin Proc. 2006; 81(3):345-52.
[13] Duncan AE. Hyperglycemia and perioperative glucose management. Curr Pharm Des. 2012; 18(38):6195-203.
[14] Samdani Fard Seyedamir Hossein AM, Rajab Targhee Marjan, Satish Hamid. Comparison of hemodynamic state and serum glucose in non-diabetic patients during non-emergency surgery. Razi Journal of Medical Sciences. 2015;22(132):87-94.
[15] Tabatabie K RKR, Salari A, Soltani F, Nasajian N, Hosseini M S et al. Compare Fluctuations in Blood Sugar Levels of Diabetic Patients during Coronary Artery Bypass Surgery (CABG) between General Anesthesia and Concurrent General and Spinal Anesthesia. hrjbaq. 2017; 2 (3) :185-192.
[16] Madineh H, Pouriamofrad E, Rajaee M. The effect of general versus spinal anesthesia on blood sugar changesduring surgery. Anesthesiology and Pain. 2012;3(2):158-0.
[17] Parish M, Abedini N, Mahmoodpoor A, Gojazadeh M, Khalilazar H. Comparison of blood glucose level in diabetics undergoing orthopedic surgeries with general or spinal anesthesia. Med J Tabriz Uni Med Sciences Health Services. 2017; 39(1):16-23.
[18] Manafi A, Zakeri H, Salahyan F, Tavassoli M, Shekoohi F, Kokabi R, et al. Blood Glucose Alterations in Spinal versus General anesthesia in those undergoing Cesarean Section Delivery. JABS. 2015; 5(1):44-50.
[19] Halkos ME, Lattouf OM, Puskas JD, Kilgo P, Cooper WA, Morris CD, et al. Elevated preoperative hemoglobin A1c level is associated with reduced long-term survival after coronary artery bypass surgery. Ann Thorac Surg. 2008; 86(5):1431-7.
[20] Abdelmalak BB, Knittel J, Abdelmalak JB, Dalton JE, Christiansen E, Foss J, et al. Preoperative blood glucose concentrations and postoperative outcomes after elective non-cardiac surgery: an observational study. Br J Anaesth. 2014; 112(1):79-88.
[2] Pomposelli JJ, Baxter JK, 3rd, Babineau TJ, Pomfret EA, Driscoll DF, Forse RA, Bistrian BR. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. JPEN J Parenter Enteral Nutr. 1998; 22(2):77-81.
[3] Doenst T, Wijeysundera D, Karkouti K, Zechner C, Maganti M, Rao V, Borger MA. Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery. J Thorac Cardiovasc Surg. 2005; 130(4):1144.
[4] Akhtar S, Barash PG, Inzucchi SE. Scientific principles and clinical implications of perioperative glucose regulation and control. Anesth Analg. 2010; 110(2):478-97.
[5] Black PR, Brooks DC, Bessey PQ, Wolfe RR, Wilmore DW. Mechanisms of insulin resistance following injury. Ann Surg. 1982; 196(4):420-35.
[6] Farrokhi F, Smiley D, Umpierrez GE. Glycemic control in non-diabetic critically ill patients. Best Pract Res Clin Endocrinol Metab. 2011; 25(5):813-24.
[7] Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87(3):978-82.
[8] Frisch A, Chandra P, Smiley D, Peng L, Rizzo M, Gatcliffe C, et al. Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care. 2010; 33(8):1783-8.
[9] Kotagal M, Symons RG, Hirsch IB, Umpierrez GE, Dellinger EP, Farrokhi ET, Flum DR. Perioperative hyperglycemia and risk of adverse events among patients with and without diabetes. Ann Surg. 2015; 261(1):97-103.
[10] Griesdale DE, de Souza RJ, van Dam RM, Heyland DK, Cook DJ, Malhotra A, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. Cmaj. 2009; 180(8):821-7.
[11] Wiener RS, Wiener DC, Larson RJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. Jama. 2008; 300(8):933-44.
[12] Polk HC Jr. Renewal of surgical quality and safety initiatives: a multispecialty challenge. Mayo Clin Proc. 2006; 81(3):345-52.
[13] Duncan AE. Hyperglycemia and perioperative glucose management. Curr Pharm Des. 2012; 18(38):6195-203.
[14] Samdani Fard Seyedamir Hossein AM, Rajab Targhee Marjan, Satish Hamid. Comparison of hemodynamic state and serum glucose in non-diabetic patients during non-emergency surgery. Razi Journal of Medical Sciences. 2015;22(132):87-94.
[15] Tabatabie K RKR, Salari A, Soltani F, Nasajian N, Hosseini M S et al. Compare Fluctuations in Blood Sugar Levels of Diabetic Patients during Coronary Artery Bypass Surgery (CABG) between General Anesthesia and Concurrent General and Spinal Anesthesia. hrjbaq. 2017; 2 (3) :185-192.
[16] Madineh H, Pouriamofrad E, Rajaee M. The effect of general versus spinal anesthesia on blood sugar changesduring surgery. Anesthesiology and Pain. 2012;3(2):158-0.
[17] Parish M, Abedini N, Mahmoodpoor A, Gojazadeh M, Khalilazar H. Comparison of blood glucose level in diabetics undergoing orthopedic surgeries with general or spinal anesthesia. Med J Tabriz Uni Med Sciences Health Services. 2017; 39(1):16-23.
[18] Manafi A, Zakeri H, Salahyan F, Tavassoli M, Shekoohi F, Kokabi R, et al. Blood Glucose Alterations in Spinal versus General anesthesia in those undergoing Cesarean Section Delivery. JABS. 2015; 5(1):44-50.
[19] Halkos ME, Lattouf OM, Puskas JD, Kilgo P, Cooper WA, Morris CD, et al. Elevated preoperative hemoglobin A1c level is associated with reduced long-term survival after coronary artery bypass surgery. Ann Thorac Surg. 2008; 86(5):1431-7.
[20] Abdelmalak BB, Knittel J, Abdelmalak JB, Dalton JE, Christiansen E, Foss J, et al. Preoperative blood glucose concentrations and postoperative outcomes after elective non-cardiac surgery: an observational study. Br J Anaesth. 2014; 112(1):79-88.
| Files | ||
| Issue | Vol 10 No 4 (2024): Autumn |
|
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/aacc.v10i4.16265 | |
| Keywords | ||
| diabetes surgery stress-induced hyperglycemia anesthetic technique age. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Jahangirifard B, Karbalaei-Musa H, Hajali MH, Kianpour P, Afsahi M. Blood Glucose Dynamics in Diabetic Patients Undergoing Elective Surgery: A Descriptive-Analytical Cross-Sectional Investigation. Arch Anesth & Crit Care. 2024;10(4):367-371.
