Diabetes Control and the Occurrence of Postoperative Hyperglycemia Among Adults With Type 1 and Type 2 Diabetes in a Tertiary Care Center.

Abstract

Background: Diabetes mellitus (DM) is a growing concern globally. DM control is indicated by hemoglobin A1c, measuring glucose levels within two to 3 months. Patients with DM who have surgery may experience postoperative hyperglycemia (POHG) which is associated with many complications. This study aimed to investigate POHG incidence among patients with DM based on their level of glycemic control. Methods: This was a retrospective cohort study of patients with DM ≥ 18 years who had orthopedic, intra-abdominal, cardiothoracic, or vascular surgery at King Abdulaziz Medical City, Jeddah, between October 2016 and October 2023. Patients with DM were considered controlled if the hemoglobin A1c was < 7%. Results: The study included 306 patients, and the majority (69.28%) experienced POHG. There was a significant association between POHG and the level of glycemic control. POHG was experienced by 32.55% of patients with controlled DM vs 67.45% of patients with uncontrolled DM. Furthermore, patients with preoperative random glucose readings (RBG) of ≥ 9.2 mmol/L had a significantly higher risk of developing POHG. Moreover, older age and male sex were associated with higher POHG risk. Conclusion: Our data indicate that the incidence of POHG was significantly greater among patients with uncontrolled DM. Patients with DM with a preoperative RBG of ≥ 9.2 mmol/L had a higher likelihood of developing POHG. Future research should include a larger sample and investigate associations between POHG, other complications, and the influence of varying levels of DM control.