Relationship Between the Timing of Preoperative Medical Visits and Day-Of-Surgery Glucose in Poorly Controlled Diabetes

Figures & data

Figure 1.  Distribution of patients according to intervals.

Left: interval between date of preoperative medical evaluation and date of surgery. Right: interval between date of hemoglobin A_1c measurement and date of surgery.

Figure 2.  Preoperative point-of-care blood glucose levels according to intervals.

Intervals are the number of days between the date of the preoperative medical evaluation and the day of surgery. The numbers above the bars indicate mean (SD) blood glucose values, and the numbers within the bars indicate the number of patients in each interval (a glucose value was missing for one patient). The asterisk indicates a significant difference (p < .01) between the mean blood glucose value for the <3-day interval and the >10-day interval.

Table 1.  Demographics of 163 patients who had diabetes mellitus and underwent an elective surgical procedure.

Variable	Result
Age, years	63 (12)
Female	85 (52)
White race	128 (79)
Preoperative HbA1c (%)	8.9 (1.0)
Duration of DM, years^†	18 (13)
Outpatient DM therapy
– Diet	9 (5)
– Oral agents and insulin	35 (22)
– Oral agents only	51 (31)
– Insulin monotherapy	68 (42)
Type of surgery
– General	38 (23)
– Urologic	36 (22)
– Orthopedic	32 (20)
– Otolaryngologic	20 (12)
– Gynecologic	16 (10)
– Plastic	14 (9)
– Neurologic	4 (2)
– Cardiothoracic	3 (2)
In-state residence	148 (91)
Underwent a POME	163 (100)
POME–surgery interval, days	18 (28)
Endocrinology evaluation	74 (45)

† Continuous data are expressed as mean (SD); categorical data as number of patients (percentage of sample).

Available for 142 patients.

DM: Diabetes mellitus; HbA_1c: Hemoglobin A_1c; POME: Preoperative medical evaluation.

Table 2.  Variables associated with preoperative glucose levels.

Variable	Estimated change (%)	95% CI	p-value
Age (years)	0.04	-0.49 to 0.57	0.88
HbA1c (%)	0.36	-5.36 to 6.42	0.90
White race (vs nonwhite)	-4.47	-17.35 to 10.41	0.53
Duration of DM (years)	-0.17	-0.68 to 0.35	0.51
Female	-0.07	-11.56 to 12.92	0.99
Type of surgery ^†	9.50	-4.47 to 25.50	0.19
Endocrinology care	0.79	-10.59 to 13.63	0.90
Outpatient DM therapy^‡	-3.5	-10.1 to 3.5	0.32
Diet	-1.61	-16.28 to 15.64	0.84
Oral agents and insulin	-3.59	-17.86 to 13.16	0.65
Oral agents only	-23.88	-42.22 to .29	0.05
POME-surgery date interval ≤10 days^§	18.13	4.51 to 33.53	<0.01

‡,†,§ Referent general surgery.

Referent insulin therapy.

Versus >10 days.

DM: Diabetes mellitus; HbA1c: Hemoglobin A1c; POME: Preoperative medical evaluation.