Abstract
Background:This study evaluated referral patterns for preoperative evaluations of patients with poorly controlled diabetes mellitus (DM) and determined whether intervals between evaluations and surgery day were associated with preoperative glucose levels.Results/methodology:In this retrospective analysis of DM patients with a hemoglobin A1c level greater than 8.0%, of the 163 patients who underwent preoperative medical evaluation, only 45% were evaluated by endocrinology. Patients who had surgery earlier than 10 days after the preoperative medical evaluation had preoperative glucose levels 18% higher than those of patients who waited more than 10 days. Preoperative outpatient contact with endocrinology was not associated with preoperative glucose level (p = 0.90).Conclusion:For poorly controlled DM, more than 10 days are needed to achieve preoperative glycemic control.
Highlights
This study evaluated referral patterns for preoperative evaluations of patients with poorly controlled diabetes mellitus (DM) and determined whether intervals between evaluations and surgery day were associated with preoperative glucose levels
45% were seen by the endocrinology service preoperatively
Patients who had surgery within 10 days after the preoperative medical evaluations (POMEs) had preoperative glucose levels 18% higher than those of patients who waited more than 10 days
Summary
This study evaluated referral patterns for preoperative evaluations of patients with poorly controlled diabetes mellitus (DM) and determined whether intervals between evaluations and surgery day were associated with preoperative glucose levels. Lay abstract: High blood sugar (hyperglycemia) can lead to surgical complications in patients with diabetes mellitus. It is best to identify patients in need of better glucose control before the day of surgery and allow enough time for them to treat their hyperglycemia. This study of patients with poorly controlled diabetes (with hemoglobin A1c levels of more than 8.0%) found that more than 10 days is needed to improve blood sugar control if a high hemoglobin A1c is detected. More effective ways of identifying these patients are needed to permit enough time to treat hyperglycemia before surgery
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