Importance of Perioperative Glycemic Control in General Surgery: A Report from the Surgical Care and Outcomes Assessment Program

Kwon, Steve; Thompson, Rachel; Dellinger, Patchen; Rogers, T.; Flum, David R.

doi:10.1016/j.jss.2011.11.457

Cited by 175 publications

(261 citation statements)

References 31 publications

Supporting

Mentioning

236

Contrasting

Unclassified

Order By: Relevance

“…[22][23][24][25][26] Some evidence supports implementing glycemic control prior to surgery, 27,28 which suggests that delaying surgery for better glycemic control in the cases of elective surgeries may be a useful option. A randomized prospective study would be needed to address the best course of action once patients without known diabetes are pre-operatively screened for glucose.…”

Section: Discussionmentioning

confidence: 99%

Preoperative glucose as a screening tool in patients without diabetes

Wang

Panizales

Hudson

et al. 2014

Journal of Surgical Research

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Preoperative glucose as a screening tool in patients without diabetes

Wang

Panizales

Hudson

et al. 2014

Journal of Surgical Research

View full text Add to dashboard Cite

“…The surgical patient population with diabetes is of particular interest given the relationship between hyperglycemia and patient outcomes. [1][2][3][4][5][6] Data on how surgical services are applying insulin therapy in the postoperative patients, however, is limited.…”

Section: Discussionmentioning

confidence: 99%

Clinical Inertia during Postoperative Management of Diabetes Mellitus: Relationship between Hyperglycemia and Insulin Therapy Intensification

Coan

Schlinkert

Beck

et al. 2013

J Diabetes Sci Technol

View full text Add to dashboard Cite

Objective:Our objective was to assess the application of insulin regimens in surgical postoperative patients with diabetes. Methods:A chart review was conducted of patients with diabetes who were hospitalized postoperatively between January 1 and April 30, 2011. Analysis was restricted to patients hospitalized for ≥3 days and excluded cases with an endocrinology consult. Insulin regimens were categorized as "basal plus short acting," "short acting only," or "none," and the pattern of use was evaluated by hyperglycemia severity according to tertiles of both mean glucose and the number of glucose measurements >180 mg/dl. Results:Among cases selected for analysis (n = 119), examination of changes in insulin use based on tertiles of mean glucose showed that use of basal plus short-acting insulin increased from 10% in the lowest tertile (mean glucose, 120 mg/dl) to 18% in the highest tertile (mean glucose, 198 mg/dl; p < .01); however, 70% of patients in the highest tertile continued to receive short-acting insulin only, with 12% receiving no insulin. Intensification of insulin to a basal plus short-acting regimen was also seen when changes were evaluated by the number of measurements >180 mg/dl (p < .01), but 70% and 12% of patients in the highest tertile still remained only on short-acting insulin or received no insulin, respectively. Conclusions:Use of basal plus short-acting insulin therapy increased with worsening hyperglycemia, but many cases did not have therapy intensified to the recommended insulin regimen-evidence of clinical inertia. Strategies should be devised to overcome inpatient clinical inertia in the treatment of postoperative patients with diabetes.

show abstract

“…[46,47] Surgery Hyperglycemia is associated with increased risk for adverse outcomes in patients undergoing surgery: more length of stay, postoperative complications, infections, and more mortality. [48,49] The recommendations and the treatment depend on the type of diabetes, surgical procedure, when patient is going to resume feeding, previous diabetic treatment, glucose control, and metabolic state of patients. [4,50] T2DM patients controlled with diet and exercise, may not need a special preoperative intervention and the glucose can be regulated with correctional regular insulin.…”

Section: Journal Of Translational Internal Medicine / Oct-dec 2016 / mentioning

confidence: 99%

Management of hospitalized type 2 diabetes mellitus patients

Marín-Peñalver

Martín-Timón

Cañizo-Gómez

2016

Journal of Translational Internal Medicine

View full text Add to dashboard Cite

Both hyperglycemia and hypoglycemia in hospitalized patients are associated with adverse outcomes including increased rates of infection, longer hospital length of stay, and even death. Clinical trials in patients with type 2 diabetes mellitus proved that by improving glycemic control, we can reduce all of them. Insulin is the preferred treatment for glycemic control in most cases, but alternative treatment options that can normalize blood glucose levels without hypoglycemia are being sought. Moreover, hospitalized patients are particularly vulnerable to severe, prolonged hypoglycemia since they may be unable to sense or respond to the early warning signs and symptoms of low blood glucose. Finally, nutritional support, corticosteroid therapy, and surgery increase the risk of hyperglycemia that leads to an increased risk of morbidity and mortality. We review the management of type 2 diabetes mellitus patients who are admitted to the general medical wards of the hospital for a procedure of intercurrent illness.

show abstract

Importance of Perioperative Glycemic Control in General Surgery: A Report from the Surgical Care and Outcomes Assessment Program

Cited by 175 publications

References 31 publications

Preoperative glucose as a screening tool in patients without diabetes

Preoperative glucose as a screening tool in patients without diabetes

Clinical Inertia during Postoperative Management of Diabetes Mellitus: Relationship between Hyperglycemia and Insulin Therapy Intensification

Management of hospitalized type 2 diabetes mellitus patients

Contact Info

Product

Resources

About