Establishing a recommended duration of blood glucose monitoring in nondiabetic patients following orthopaedic surgery

Abstract

Previous studies have demonstrated that blood glucose (BG) levels should be monitored for at least 1 week after orthopaedic surgery in diabetic patients, but no study has determined how long nondiabetic patients should be monitored. As postoperative elevations in BG have deleterious effects, determining a duration for monitoring the BG of nondiabetic patients after major orthopaedic surgery is needed to detect hyperglycemic events, create comprehensive protocols for nondiabetic orthopaedic patients, and reduce adverse outcomes. A retrospective study was conducted including consecutive patients who underwent a major orthopaedic surgery at a community hospital. A BG level of 150 mg/dl was the cutoff used to define hyperglycemia according to our institutional guidelines. A χ2, analysis of variance, and subgroup analysis were performed separately. Greater than 67% of nondiabetic patients experienced a high BG level (>150 mg/dl) after surgery. We found that nondiabetic patients reached their postoperative maximum BG level at 20 h, which was sooner compared to diabetic patients. We discovered more than 92% of nondiabetic patients reached a maximum BG levels within the first 72 h of hospitalization, while the BG levels after this period were found to be within normal limits in greater than 87% of cases. We propose that BG management be instituted in nondiabetics from the preoperative period to 72 h after surgery, including patients who are same‐day discharges. There may not be a need to continue inpatient BG monitoring beyond the first 72 h for nondiabetic hospitalized patients with extended hospitalizations.

Nursing care of TURP and hyperglycemia integrating symptoms management model

“…48 Monitor blood glucose levels and report any significant fluctuations or consistently high readings to the healthcare team. 49 In addition, the patients should stay hydrated by consuming adequate fluids, as dehydration affects blood glucose levels. 50 Nutritional management by considering proper nutrition can help support healing and reduce the risk of TURP complications such as long-term hyperglycemia.…”

“…Communication with the healthcare team will help the patient to inform them about diabetes and any specific details related to the management plan 48 . Monitor blood glucose levels and report any significant fluctuations or consistently high readings to the healthcare team 49 . In addition, the patients should stay hydrated by consuming adequate fluids, as dehydration affects blood glucose levels 50 .…”