Preoperative Optimization of Diabetic Patients

Condition(s) studied

Investigational drug(s) / intervention(s)

Surgery: this study in observational study, no intervention.

Study summary

Diabetic patients, as part of preoperative evaluation, should have glycated hemoglobin (HbA1C) measured. HbA1C provides information on longterm glucose control. There is a suggestion in the literature that elevated A1C levels predict a higher rate of postoperative adverse events, including infections, myocardial infarction, and mortality. It is unclear whether chronic glycemia, as reflected in raised HbA1C level, is the risk factor for adverse perioperative events or whether it is a surrogate measure for poor perioperative glucose management. Conversely, in a retrospective analysis of 431,480 surgeries perioperative glucose was predictive of increased 30-day mortality, but that HbA1C was a less useful predictor of this measure. In our experience of at the University of Alberta Preadmission Clinic there is significant variability with respect to whether diabetic patients have a valid HbA1C measurement i.e. within 3 months of surgery. If a valid measurement is present, there is also considerable variability with respect to diabetes control.

Eligibility

Primary outcome measure(s)

• Prevelance of diabetes among surgical population — 11/2019-12/2023
  Determine the incidence of diabetes in the surgical population
• HB1AC measuerment in diabetic patients — 11/2019-12/2023
  Determine the incidence of valid HbA1C in diabetic patients presenting for surgery
• Long term diabetes control among surgical patients — 11/2019-12/2023
  Determine long-term diabetes control through assessment of HbA1C values in diabetic patients presenting for surgery

Trial sites (1)

More University of Alberta trials in Canada

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