Chronic Glycemic Control in Surgical Patients admitted at a Tertiary Care Hospital

Abstract

Background: Surgeons are performing millions of operations on diabetic patients daily, and lack of awareness among diabetic patients is leading to complications. Objective: To determine chronic glycemic control in general surgical patients admitted at a tertiary care hospital. Methodology: This was a cross-sectional study conducted from June 2018 to January 2019, on fifty-seven consecutive patients, suffering from diabetes and needing surgical intervention in any form were included in this study. Diabetes status in terms of HbA1c, causes of admission to the surgical ward, and intervention done were noted. Data were analyzed by using SPSS 20. Results: Among these diabetic patients, 46 (80.70%) were male, and 36 (63.16%) were known diabetics. HbA1c level was normal in 9 (15.79%) patients, pre-diabetic in 13 (22.81%) and uncontrolled diabetic in 35 (61.4%) patients. Aetiologically diabetic foot was seen in 36 (63.16%) patients, abdominal catastrophe 12 (21.05%), leg swelling 7 (12.09%), 5 (8.77%) scrotal abscess, carbuncles 4 (7.02%), miscellaneous 5 (8.77%). Incision drainage and closure were done in 10 (17.54%), drainage wound debridement, decompression of compartment syndrome, and constructive procedure in 11 (19.3%), laparotomy 8 (8.77%) and watchful conservation in 4 (7.01%) patients. Two patients were saved from the mortal blow of the diabetic coma.  Hypertension and nephropathy were seen in 8 patients each, and 5 patients have Hepatitis C, and 1 patient has ischemic heart disease. Conclusion: This study showed that many patients did not know their diabetes status, two-third of patients were having uncontrolled diabetes. There is a need for proper assessment and management of diabetic patients by consultants and young doctors in every discipline of medicine, especially surgery.