Relationship between the timing of preoperative medical visits and day-of-surgery glucose in poorly controlled diabetes

Salma I Patel; Bithika M Thompson; Ryan Y McLemore; M'hamed Temkit; Richard T Schlinkert; Heidi A Apsey; Curtiss B Cook

doi:10.4155/fsoa-2016-0009

Relationship between the timing of preoperative medical visits and day-of-surgery glucose in poorly controlled diabetes

Future Sci OA. 2016 Jun 2;2(2):FSO123. doi: 10.4155/fsoa-2016-0009. eCollection 2016 Jun.

Authors

Salma I Patel¹, Bithika M Thompson¹, Ryan Y McLemore¹, M'hamed Temkit¹, Richard T Schlinkert², Heidi A Apsey², Curtiss B Cook¹

Affiliations

¹ Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA; Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
² Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA; Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA.

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 A_1c 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.

Keywords: anesthesia; diabetes mellitus; hyperglycemia; perioperative; surgery.