Effect of postop hyperglycemia, preop hemoglobin on outcomes in diabetic patients

Editor's Note

Early postoperative hyperglycemia was linked to increased readmissions after gastrointestinal surgery in insulin-dependent diabetic patients, but elevated preoperative hemoglobinA1c was not, this study finds.

Higher preoperative hemoglobinA1c levels were associated with increased postoperative glucose level checks and insulin use as well as lower rates of postoperative complications.

Though many advocate for deferring elective surgery in patients with elevated levels of hemoglobinA1c until it is optimized, the results suggest that proceeding with surgery may be acceptable as long as there is vigilant postoperative glucose level monitoring and treatment, the authors say.

Are levels of preoperative hemoglobin A Question 1c or early postoperative glucose more useful at predicting postoperative complications and readmission following gastrointestinal surgery? This retrospective observational cohort study of 23 094 operations at 117 Veterans Affairs medical centers found that peak postoperative glucose levels of less than 250 mg/dL were significantly associated with increased 30-day readmissions.