Diabetics are more likely to have high blood glucose after joint surgery

People with diabetes who undergo joint replacement surgery are at a significantly higher risk of having high blood glucose after surgery, which increases their risk of getting an infection or other complications, according to a new study by researchers from the Hospital of Special Surgery (HSS) of New York. City and the Ochsner Health System in New Orleans.

Previous studies have shown that high blood sugar, or hyperglycemia, during the perioperative period of orthopedic joint replacement surgery is a risk factor for infection. The new study, by Bradford Waddell, MD, hip and knee surgeon at the HSS, looked into the issue more closely. It included patients with a diagnosis of diabetes whose blood sugar was controlled with the help of insulin hormone and compared them to diabetics without the need for insulin. Patients requiring insulin may be considered to have more severe diabetes and are more likely to experience high blood sugar during the perioperative period, said Dr. Waddell.

For the new study, Dr. Waddell and colleagues reviewed the medical records of 773 men and women who had total hip and / or knee replacements between 2011 and 2016. Of these, 437 were diagnosed with insulin-dependent diabetes mellitus. , while 336 had not been diagnosed with the condition.

Patients with insulin-dependent diabetes were five times more likely to develop hyperglycemia or high blood glucose after surgery (odds ratio, 5.2, blood glucose over the previous three months – measured by hemoglobin A1c – was more likely to have postoperative hyperglycemia, regardless of the group they were in. An A1c greater than 6.59 for those with insulin-dependent diabetes and 6.6% for those without the disease was badociated with high risk of postoperative hyperglycemia (P

Despite the increased risk of increased blood sugar levels after surgery, however, the incidence of postoperative joint infections did not differ between the two groups of patients. However, Dr. Waddell pointed out that the study was limited by the fact that it was insufficiently powerful to detect the risk of infection.

Dr. Waddell said that the bottom line for clinicians is "if your patient has diabetes and is dependent on insulin, you need to be more aware of controlling his or her blood sugar during the perioperative period because it presents a risk. higher".

Provided by
Hospital for Special Surgery