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Is routine preoperative assessment for diabetes mellitus nec | 18141
International Research Journals

Is routine preoperative assessment for diabetes mellitus necessary in patients without a family history?.

Abstract

Ashindoitiang John Adi and Akinlolu O.O.

The study was carried out to determine the clinical value of routine blood glucose testing in patients undergoing elective surgical procedures. Diabetes is very common disorder. It affects approximately 8% of the population in the United States but the prevalence in Nigeria is not known but it is increasingly a common medical condition. DM is frequently encountered in surgical patients that have not been diagnosed with the disorder. Furthermore, surgical procedures are more common in diabetics than non diabetics because eighty percent of diabetics are over 40 years and surgical procedures are more common in this age group. Again diabetes and its complications predispose to variety of surgical disorders. With the increasing prevalence of diabetic patients requiring surgery and the enormous risk of complications associated with the disease, adequate preoperative assessment is mandatory. We studied 75 patients consecutively with various surgical disorders that underwent elective surgery within a period of 1 year (May 2009-April 2010). Each patient had fasting blood sugar (FBS) testing before surgery. In addition patient’s family history of diabetes, weight, height, and hip and waist size were obtained and in entered into a structured proforma. The patients with dysglycemia were revaluated with repeat FBS and HbA1c. The BMI and Waist/Hip ratio were later calculated, A total of 75patients were recruited. Children below the age of 18years were excluded. There were 54males and 21females giving M: F 2.5:1. The age range was between 18-80years with a mean of 48.7years. A total of 21patients (28%) had FBS>126mg/dl and HbA1c >6.5%. Hyperglycemia of >126mg/dl and HbA1c>6.5% increases with age. 16 patients in this study had BMI above 30(obese). 11 out of the 16 had FBS> 126mg/dl p<0.001 Also 13 patients had positive family history of diabetes, 9 out of the 13 had FBS>126mg/dl. The waist/hip ratio did not show any significant value in predicting patients with disordered blood glucose. Hyperglycemia was found in the patients with unusual infections namely palmar abscess and anorectal abscess. Diabetes is common disorder and is frequently encountered in surgical patients who have not been diagnosed with the disorder. From this study we recommend screening for diabetes in surgical patients that are above 40years, patients with family of the disorder, obese individuals and patients with unusual infections.

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