A study of perioperative control level of plasma glucose in patients with diabetes mellitus

ZHANG Guo-ying, DENG Wei, LI Xiao-yu. Department of Endocrinology , Ji Shui Tan Hospital, Beijing 100035 , China  

Objective To explore perioperative control level of plasma glucose in patients with diabetes mellitus. Methods A total of 163 patients with diabetes were divided into two groups, Group A with fasting plasma glucose (FPG)≤6.9 mmol/L, and Group B with FPG≥7.0 mmol/L. FPG, plasma glucose two hours after glucose load (2hPG), urine ketone, hypoglycemia, days to use antibiotics, and days of operation wound healed were observed. Results FPG level [(5.9±0.7) mmol/L] before surgical operation and plasma glucose level [(7.5±1.7) mmol/L]during operation in Group A were lower than those in Group B [(8.1±2.1) mmol/ L and(13.4±3.7) mmol/L], with P 0.05. FPG level after operation in Group A [(6.6±2.0) mmoVL] was also lower than that in Group B [(9.3±2.5) mmol/L], with P0.01. Use of insulin dose in Group A was more than that of Group B[(36.6±3.4) vs (30.1±5.2) U/d, P 0.01] , and time for preoperative preparation in Group A was longer than that in Group B [(22.5±10.2) vs (16.9±11.4) d], P 0.05. There was no significant difference in postoperative hypoglycemia reaction between the two groups. Incidence of postoperative diabetic ketoacidosis in Group B (10.53% ) was higher than that in Group A (2.30%) ,with P 0.05. Days of antibiotics use after operation in Group B [(9.1±2.5) d]was longer than that in Group A [ (6.5±1.8) d] , with P 0.01. But, there was no significant difference in days of operation wound healed. Conclusions It is helpful for diabetic patients to control their perioperative plasma glucose level around normal for controlling their postoperative level of plasma glucose and reducing risk of diabetic ketoacidosis, postoperative infection and non-healing of wound. Plasma glucose should also be closely monitored for reducing occurrence of hypoglycemia during operation.

【Key Words】： Diabetes mellitus Intraoperative period Blood glucose
【CateGory Index】： R619
【DOI】： CNKI:SUN:ZHQK.0.2003-02-025

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