Blood Glucose Variation in Non-diabetic Patients Undergoing Intraabdominal Surgery

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Chananya Potisuk
Kornchanok Kromcharee
Wacharin Sindhvananda


Background: Perioperative hyperglycemia in
non-diabetes (non-DM) has been reported as much
as 30%. Glycemic variability (GV) becomes a better
predictive index of complications than hyperglycemia.
High GV in non-DM was associated with more severity of
complications than diabetes. There has been no study of
GV in non-diabetes undergoing intraabdominal surgery.
Objectives: To evaluate 1) incidence of hyperglycemia/
hypoglycemia 2) perioperative GV and 3) risk factors of
high GV
Methods: A prospective observational study was
performed after IRB approval. Adult non-diabetic patients
undergoing intraabdominal surgery were recruited.
Predicted operation time (<2 h) and planned sole regional
anesthesia were excluded. Selection criteria of non-DM
were defined. Blood glucose (BG) was monitored by POCT
every hour. Controls of BG were tight or non-tight controls
as appropriate. GV was calculated in the form of SD. Descriptive statistics and Mantel-Haenszel odds ratio
were used.
Results: Final patients of 120 were retained for analysis.
The 1st and 2nd most common types of surgery were hollow
viscus organ (50.83%) and solid organ (36.57%). Surgical
techniques was open (81.33%) and laparoscopic (16.67%)
approaches. Combined continuous epidural with general
anesthesia (CEA-GA) was performed (67.5%). Hyperglycemia
(>180 mg/dL) and hypoglycemia (<60 mg/dL) were 15%
and 5%, respectively. Patients with hyperglycemia of 15/18
(12.5%) received BG control. Hyperglycemia began during
the 2nd operative hour and mostly occurred in the 3rd hour.
44% of patients exhibited perioperative high GV. Solid organ
surgery was a significant risk factor (OR = 2.25).
Conclusion: Hyperglycemia, high GV and hypoglycemia
can occur in non-DM undergoing intraabdominal surgery.


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