Purpose: Hyperglycemia and elevated glycosylated hemoglobin (HbA 1c) are associated with perioperative morbidity in patients with diabetes, but the relationship between long-term glycemic control and perioperative glucose control is unknown. The purpose of this study was to determine the relationship between glycosylated hemoglobin (HbA1c) and perioperative glucose in fasting patients with type 2 diabetes undergoing elective non-cardiac surgery. Methods: This was a prospective observational study of 244 adult patients with type 2 diabetes who were evaluated before elective non-cardiac surgery at a preoperative medicine clinic in a tertiary care medical centre during the period September 2004 to May 2005. Preoperative HbA1c levels were determined, and preoperative and postoperative glucose values were measured on the day of surgery. The primary outcome variables were preoperative and postoperative blood glucose values. Results: Half of all study patients had an HbA1c ≥ 7%, including 23% of patients with HbA1c ≥ 8%. HbA1c levels predict preoperative glucose levels, and preoperative glucose levels and duration of surgery predict postoperative glucose levels. Glucose levels in one-third of the patients with type 2 diabetes decreased during surgery without administration of insulin or glucose-regulating medications. Conclusion: HbA1c values may serve as biomarkers for glucose control during the immediate perioperative period in patients with type 2 diabetes undergoing elective surgery.
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine