PREOPERATIVE OPTIMIZATION OF DIABETIC PATIENTS UNDERGOING SURGERY
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Abstract
Introduction: For patients undergoing surgery, an estimated 20% has diabetes, and there is an associated increased risk of morbidity and mortality of up to 50% higher compared to patients without diabetes.
Objectives: The main objective of the study is to find the preoperative optimization of diabetic patients undergoing surgery.
Methodology of the study: This prospective observational study was conducted at Ayub Teaching Hospital Abbottabad from June 2022 to June 2023. Data were collected from 450 patients suffering from DM and undergoing surgery. Each patient underwent a comprehensive preoperative evaluation, including medical history data, physical examination, laboratory investigations, glycated hemoglobin, fasting blood glucose, lipid profile and assessment of comorbidities. Glycemic control was optimized through a combination of medication adjustments, dietary modifications, and lifestyle interventions.
Results: Data were collected from 450 patients from both genders. mean age of participants was 62.01 ± 8.98 years, with a preoperative HbA1c level of 7.2± 1.0, suggesting moderate glycemic control. A considerable proportion of patients had controlled hypertension (80%) and dyslipidemia (70%), reflecting effective management of these comorbidities. Additionally, 30% of patients exhibited peripheral neuropathy, highlighting its prevalence in diabetic individuals undergoing surgery. High medication adherence among diabetic patients undergoing surgery, with 85% adhering to oral antidiabetic agents and 90% to insulin therapy. Additionally, 80% adhered to antihypertensive agents, 75% to statins, and 85% to antiplatelet agents.
Conclusion: It is concluded that preoperative glycemic control is important for optimizing outcomes in diabetic patients undergoing surgery.
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Dr Abeer Jehanzeb khan
Fcps General Surgery Medical Officer Surgical ICU Khyber Teaching Hospital
Dr Waqar Malak
Resident Surgeon Ayub Teaching Hospital Abbottabad
Dr Namra Javed
House Officer General Surgery Mercy teaching Hospital Peshawar
Nazan Hassan
Senior Registrar Surgical Unit-11, Benazir Bhutto Hospital Rawalpindi
Dr Mir Baz Khan
MTI-Bacha Khan Medical Complex Swabi