A COMPARATIVE STUDY ON THE EFFECT OF GENERAL ANAESTHESIA ON BLOOD GLUCOSE LEVELS IN NON-DIABETIC AND CONTROLLED DIABETIC PATIENTS: AN OBSERVATIONAL STUDY AT S. M. S. MEDICAL COLLEGE, JAIPUR
DOI:
https://doi.org/10.22159/ijcpr.2024v16i1.4013Keywords:
Diabetes, Surgery, Perioperative management, Hemodynamic responses, Blood glucose levels, Stress response, Individualized treatmentAbstract
Objective: Diabetes, a complex metabolic disorder, poses significant challenges during surgery due to its association with chronic hyperglycemia. Surgical stress triggers hormonal changes, impacting glucose homeostasis. With an increasing global prevalence of diabetes, understanding the interplay between surgery, stress, and diabetes becomes crucial for perioperative management.
Methods: This hospital-based cross-sectional observational study included 222 patients (111 non-diabetic and 111 controlled diabetic) undergoing elective surgery. Demographic data, hemodynamic parameters, and blood glucose levels were assessed at various intervals. Statistical analyses compared age, gender, blood glucose levels, and hemodynamic responses between the two groups.
Results: Demographic parameters were comparable between non-diabetic and controlled diabetic groups. Hemodynamic responses, including heart rate and blood pressure, showed no significant differences during the surgery. Blood glucose levels were similar preoperatively and up to 30 min post-intubation. However, a significant difference was observed after 5 min of extubation, with controlled diabetic patients exhibiting higher levels. Variations in blood glucose levels after extubation were statistically significant, emphasizing the importance of postoperative monitoring.
Conclusion: This study highlights the intricate relationship between surgery, stress, and diabetes, emphasizing the need for tailored perioperative management. Close monitoring, especially during critical moments, is essential to ensure optimal glucose control and mitigate complications. The findings align with existing literature, reinforcing the importance of individualized approaches for diabetic patients undergoing surgery.
Downloads
References
American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43Suppl 1:S14-31. doi: 10.2337/dc20-S002, PMID 31862745.
International Diabetes Federation. IDF diabetes atlas. 9th ed. Brussels, Belgium: International Diabetes Federation; 2019.
World Health Organization. Definition, diagnosis, and classification of diabetes mellitus and its complications: report of a WHO Consultation. Part 1. Diagnosis and classification of diabetes mellitus. Geneva, Switzerland: World Health Organization; 2016.
Frisch A, Chandra P. Perioperative management of diabetes: a review. Anesth Essays Res. 2018;12(3):539-45.
Desborough JP. The stress response to trauma and surgery. Br J Anaesth. 2000;85(1):109-17. doi: 10.1093/bja/85.1.109, PMID 10927999.
Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB. American association of Clinical Endocrinologists and american diabetes association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15(4):353-69. doi: 10.4158/EP09102.RA, PMID 19454396.
Cousley A. Stories of dignity within healthcare: research, narratives and theories. J Perioper Pract. 2018;28(1-2):6. doi: 10.1177/1750458917742063.
Sathishkumar S, Muthukumar P. Impact of diabetes on the outcomes of surgical patients: a review. Int J Surg Open. 2018;10:7-14.
Gandhi GY, Nuttall GA, Abel MD, Mullany CJ, Schaff HV, Williams BA. Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients. Mayo Clin Proc. 2005;80(7):862-6. doi: 10.4065/80.7.862, PMID 16007890.
Frisch A, Chandra P, Smiley D, Peng L, Rizzo M, Gatcliffe C. Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care. 2010;33(8):1783-8. doi: 10.2337/dc10-0304, PMID 20435798.
Sato H, Carvalho G, Sato T, Lattermann R, Matsukawa T, Schricker T. The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery. J Clin Endocrinol Metab. 2010;95(9):4338-44. doi: 10.1210/jc.2010-0135, PMID 20631016.
Latham R, Lancaster AD, Covington JF, Pirolo JS, Thomas CS. The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery patients. Infect Control Hosp Epidemiol. 2001;22(10):607-12. doi: 10.1086/501830, PMID 11776345.
Published
How to Cite
Issue
Section
Copyright (c) 2024 RAJEEV SHARMA, AJAY SINGH, SANDEEP CHHIPA
This work is licensed under a Creative Commons Attribution 4.0 International License.