950-P: Point-of-Care Glucose Testing in the Preoperative Area prior to Surgery: Is It Useful?

Abstract

Background: Maintaining perioperative glycemic control is important for patients undergoing a surgical procedure to prevent postoperative complications. Methods: The authors conducted a pilot project designed to detect and manage perioperative hyperglycemia in a women’s hospital in Virginia. Point of Care (POC) fasting blood glucose tests were performed on the day of surgery in high risk patients. Criteria for screening were: known diabetes, BMI >30 and age > 45. Patients with hyperglycemia were treated according to a protocol using a bolus of intravenous insulin and/or insulin infusion. Results: Of the 1478 patients undergoing surgery, 1187 (80%) met criteria for POC glucose testing during the 12 week pilot. Forty-eight percent had fasting blood glucose values of either impaired glucose/prediabetes (100 mg/dL-125mg/dl) or higher (see figure) . Seven patients had a fasting glucose of > 200 mg/dl and met criteria to receive insulin in the O.R. Six of these seven patients had known diabetes. A single patient with previously undiagnosed diabetes qualified for insulin therapy. In no circumstance was surgery delayed or cancelled due to hyperglycemia. Conclusion: Screening for hyperglycemia in the preoperative area is a valuable tool for identifying patients who may benefit from intraoperative insulin therapy. The vast majority of patients who require rescue insulin therapy in the operating room have known diabetes. Disclosure S.Ahmad: None. K.K.Edmiston: None. B.Good: None. M.W.Jeffery: Other Relationship; Medtronic. P.W.Clougherty: None. S.Clement: Research Support; Novo Nordisk. Funding Division of Endocrinology, Medicine Service Line, Inova Health System