2021, Number 4
<< Back Next >>
Acta Med 2021; 19 (4)
Preoperative hyperglycemia in patients without diabetes mellitus subjected to elective surgeries
Zhou X, Portela OJM, Zaragoza LG, Ocampo VDBP
Language: Spanish
References: 13
Page: 506-509
PDF size: 146.80 Kb.
ABSTRACT
Introduction: Hyperglycemia can increase perioperative morbidity and mortality. Therefore, its timely recognition favors a better surgical result. Patients with hyperglycemia are more likely to be hospitalized than those without diabetes, as many of these patients are not diagnosed prior to hospitalization.
Objective: To determine the incidence of preoperative hyperglycemia in patients who do not have a diagnosis of diabetes mellitus.
Material and methods: Patients with ASA 1 and 2, age ? 18 years, elective surgery were included. An observational, prospective, cross-sectional study was carried out. Preoperative capillary glycemia was recorded. Data collection is expressed in averages and percentages.
Results: 509 patients with ASA 1 and 2 of which 116 patients (22.7%) were excluded. Patients included 393 (n = 393). 106 patients with preoperative hyperglycemia (27%) were identified and eight patients (7.54%) with glycemia ≥ 126 mg/dL were found, mean hyperglycemia was 94 mg/dL ± 14.2. Is subdivided hyperglycemic patients by age group, and the incidence of hyperglycemia increases with age.
Conclusions: In this study, hyperglycemia was present in 17.7% of patients of 18-40 years and up to 62% in patients more than 80 years without DM. The determination of glucose must be considered as an efficient preoperative test.
REFERENCES
Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer RG et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004; 27 (2): 553-591.
Smiley DD, Umpierrez GE. Perioperative glucose control in the diabetic or nondiabetic patient. South Med J. 2006; 99 (6): 580-591.
http://www.insp.mx/avisos/3652-diabetes-en-mexico.html
Alberti KGMM, Gill GV. The care of the diabetic patient during surgery. En: Alberti KGMM, Zimmet P, DeFronzo RA, Keen H, eds. International textbook of diabetes mellitus. 2nd ed. Chichester: Wiley; 1997, 1243-1253.
Debing E, Aerden D, Van den Brande P. Diabetes mellitus is a predictor for early adverse outcome after carotid endarterectomy. Vasc Endovascular Surg. 2011; 45 (1): 28-32.
Gandhi GY, Nuttall GA, Abel MD, Mullany CJ, Schaff HV, O'Brien PC et al. Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial. Ann Intern Med. 2007; 20: 233-243.
Chan RP, Galas FR, Hajjar LA, Bello CN, Piccioni MA, Auler JO Jr. Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial. Clinics (Sao Paulo). 2009; 64 (1): 51-60.
Leibowitz G, Raizman E, Brezis M, Glaser B, Raz I, Shapira O. Effects of moderate intensity glycemic control after cardiac surgery. Ann Thorac Surg. 2010; 90 (6): 1825-1832.
The NICE-SUGAR Study Investigators. Intensive verses conventional glucose control in critically ill patients. N Engl J Med. 2009; 360: 1283-1297.
Pontes JPJ, Mendes FF, Vasconcelos MM, Batista NR. Evaluation and perioperative management of patients with diabetes mellitus. Braz J Anesthesiol. 2018; 68 (1): 75-86.
Alserius T, Anderson RE, Hammar N, Nordqvist T, Ivert T. Elevated glycosylated haemoglobin (HbA1c) is a risk marker in coronary artery bypass surgery. Scand Cardiovasc J. 2008; 42 (6): 392-398.
Knapik P, Ciesla D, Filipiak K, Knapik M, Zembala M. Prevalence and clinical significance of elevated preoperative glycosylated hemoglobin in diabetic patients scheduled for coronary artery surgery. Eur J Cardiothorac Surg. 2011; 39 (4): 484-489.
Duggan EW, Carlson K, Umpierrez GE. Perioperative hyperglycemia management: an update [published correction appears in anesthesiology. 2018; 129 (5): 1053. Anesthesiology. 2017; 126 (3): 547-560.