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Peri-operative management of diabetes mellitus - A survey of current practices among Indian anesthesiologists

BACKGROUND AND AIMS: Increased burden of diabetes in India has resulted in a spurt in the number of patients with diabetes posted for surgeries. The paucity of national guidelines can lead to marked practice variations in the peri-operative management of diabetes. This survey intends to discern curr...

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Autores principales: Priya, Vansh, Bais, Prateek S., Rastogi, Amit, Shamim, Rafat, Aggarwal, Anil, Patro, Abinash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661637/
https://www.ncbi.nlm.nih.gov/pubmed/38025580
http://dx.doi.org/10.4103/joacp.joacp_463_21
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author Priya, Vansh
Bais, Prateek S.
Rastogi, Amit
Shamim, Rafat
Aggarwal, Anil
Patro, Abinash
author_facet Priya, Vansh
Bais, Prateek S.
Rastogi, Amit
Shamim, Rafat
Aggarwal, Anil
Patro, Abinash
author_sort Priya, Vansh
collection PubMed
description BACKGROUND AND AIMS: Increased burden of diabetes in India has resulted in a spurt in the number of patients with diabetes posted for surgeries. The paucity of national guidelines can lead to marked practice variations in the peri-operative management of diabetes. This survey intends to discern current peri-operative practices among anesthesiologists working in medical colleges, tertiary care government, and private health care institutes of the country. MATERIAL AND METHODS: An anonymous online survey comprising of 25 closed-ended questions was conducted using Google Forms® and disseminated through social media, emails, and messaging platforms. The questionnaire dealt primarily with the peri-operative management of diabetes in patients scheduled for elective surgery. The survey was conducted over a period of 1 month and targeted anesthesia resident trainees with more than 1-year experience, senior residents, and consultants working in India. RESULTS: Statistically significant difference was observed between the three types of health facilities with respect to prior evaluation for diabetes (P = 0.007), prioritizing operative list (P = 0.006), hospital encouragement of day care surgery (P < 0.001), glycated hemoglobin level (HbA1c) level >8.5 for postponement of surgery (P < 0.05), insulin infusion preference (P < 0.001), hourly intra-operatively capillary blood glucose (CBG) assessment (P = 0.021), and avoiding peri-operative use of Ringer’s lactate (RL) (P = 0.025). CONCLUSION: This survey primarily highlights the lack of prioritizing the operative list, early discontinuation of metformin, and reduced tendency to consider diabetics for day care surgeries.
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spelling pubmed-106616372023-07-01 Peri-operative management of diabetes mellitus - A survey of current practices among Indian anesthesiologists Priya, Vansh Bais, Prateek S. Rastogi, Amit Shamim, Rafat Aggarwal, Anil Patro, Abinash J Anaesthesiol Clin Pharmacol Original Article BACKGROUND AND AIMS: Increased burden of diabetes in India has resulted in a spurt in the number of patients with diabetes posted for surgeries. The paucity of national guidelines can lead to marked practice variations in the peri-operative management of diabetes. This survey intends to discern current peri-operative practices among anesthesiologists working in medical colleges, tertiary care government, and private health care institutes of the country. MATERIAL AND METHODS: An anonymous online survey comprising of 25 closed-ended questions was conducted using Google Forms® and disseminated through social media, emails, and messaging platforms. The questionnaire dealt primarily with the peri-operative management of diabetes in patients scheduled for elective surgery. The survey was conducted over a period of 1 month and targeted anesthesia resident trainees with more than 1-year experience, senior residents, and consultants working in India. RESULTS: Statistically significant difference was observed between the three types of health facilities with respect to prior evaluation for diabetes (P = 0.007), prioritizing operative list (P = 0.006), hospital encouragement of day care surgery (P < 0.001), glycated hemoglobin level (HbA1c) level >8.5 for postponement of surgery (P < 0.05), insulin infusion preference (P < 0.001), hourly intra-operatively capillary blood glucose (CBG) assessment (P = 0.021), and avoiding peri-operative use of Ringer’s lactate (RL) (P = 0.025). CONCLUSION: This survey primarily highlights the lack of prioritizing the operative list, early discontinuation of metformin, and reduced tendency to consider diabetics for day care surgeries. Wolters Kluwer - Medknow 2023 2023-05-29 /pmc/articles/PMC10661637/ /pubmed/38025580 http://dx.doi.org/10.4103/joacp.joacp_463_21 Text en Copyright: © 2023 Journal of Anaesthesiology Clinical Pharmacology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Priya, Vansh
Bais, Prateek S.
Rastogi, Amit
Shamim, Rafat
Aggarwal, Anil
Patro, Abinash
Peri-operative management of diabetes mellitus - A survey of current practices among Indian anesthesiologists
title Peri-operative management of diabetes mellitus - A survey of current practices among Indian anesthesiologists
title_full Peri-operative management of diabetes mellitus - A survey of current practices among Indian anesthesiologists
title_fullStr Peri-operative management of diabetes mellitus - A survey of current practices among Indian anesthesiologists
title_full_unstemmed Peri-operative management of diabetes mellitus - A survey of current practices among Indian anesthesiologists
title_short Peri-operative management of diabetes mellitus - A survey of current practices among Indian anesthesiologists
title_sort peri-operative management of diabetes mellitus - a survey of current practices among indian anesthesiologists
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661637/
https://www.ncbi.nlm.nih.gov/pubmed/38025580
http://dx.doi.org/10.4103/joacp.joacp_463_21
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