New York: People with diabetes who undergo joint replacement surgery run a higher risk of experiencing elevated blood sugar levels after surgery, increasing their chances of developing infections and other complications, a new study suggested.
Patients with insulin-dependent diabetes were more than five times as likely as patients without the condition to develop hyperglycaemia or high blood sugar after surgery, researchers, including Bradford Waddell of the Hospital for Special Surgery (HSS) in the US said.
"If your patient develops diabetes and is dependent on insulin, you need to be aware of controlling their blood sugar levels in the perioperative period because they are at greater risk," Waddell said.
For the study, presented at the annual meeting of the American Academy of Orthopedic Surgeons in 2019, the team reviewed medical reviews of 773 men and women who had undergone total hip or knee replacement surgery between 2011 and 2016.
Of these, 437 had insulin-dependent diabetes, while 336 did not have the condition. It included patients diagnosed with diabetes whose blood sugar was controlled using the hormone insulin and compared those with diabetics who did not need insulin.
Patients who require insulin may be considered to have more severe diabetes and are more likely to experience increased blood glucose in the peri-operative period, Waddell said.
Patients with higher blood glucose in the previous three months – as measured by hemoglobin A1c – were more likely to have post-operative hyperglycemia, regardless of which group they were in.
Hemoglobin A1c above 6.59 for people with insulin-dependent diabetes and 6.6 without the condition was associated with an increased risk of postoperative hyperglycaemia.
Despite the increased risk of raising blood sugar after surgery, the incidence of post-operative joint infections was not different between the two groups of patients. The author also noted that a limitation of the study was that it was too weak to detect the risk of infection.