Endocrine Abstracts

Introduction: Perioperative hyperglycemia is associated with several adverse effects, including infection and cardiovascular events. Glycemic control is likely to be beneficial in reducing postoperative mortality.

Objectives: Our study aims to assess glycemic balance in the perioperative period and the impact of glycemic imbalance on postoperative complications.

Patients and Methods: A retrospective descriptive study was conducted on 185 patients hospitalized in the surgical departments of CHU Ibn Rochd Casablanca, from January 2022 to January 2023. The analysis was performed using the SPSS software.

Results: The average age was 60.2 years, with a female predominance (sex ratio: 1.26). The average duration of diabetes was 9.6 years. Type 2 diabetes accounted for 94.7% of cases, and type 1 diabetes for 4.9% of cases. An endocrinologist’s opinion was sought preoperatively in 76.8% of cases and postoperatively in 23.2% of cases. The glycemic imbalance was judged based on HbA1C in 35.7% of cases and on a glycemic cycle with an average blood glucose level of 2.6 g/l in 55.7% of patients. The average HbA1C was 9.5%. Regarding treatment, 37.8% of patients were on oral antidiabetic drugs (ADO), 52.6% were on insulin therapy, and 2% were on a diet. All patients were put on insulin therapy (basal-bolus in 84.2% of cases and rapid bolus in 14.7% of cases). Surgical management was urgent in 89.4% of patients. Glycemic control was achieved in an average of 5.2 days. Among our patients, 6.3% experienced postoperative infectious complications, and one patient died from a pulmonary embolism.

Conclusion: Preoperative identification of patients with poorly controlled diabetes and intensification of treatment improve glycemic control, reduce the risk of complications, and shorten hospital stays.