Diabetes Control Benefits Surgery
Good Blood Sugar Control May Help Avoid Infection After Surgery
April 17, 2006 -- People with diabetesdiabetes may have a new reason to get their blood sugar under control.
A new study shows that diabetes patients who had good control of their blood sugar for at least two or three months before surgery were more likely to avoid postsurgery infections.
The study, published in the Archives of Surgery, comes from doctors including Annika Dronge, MD, of the Veterans Affairs Connecticut Healthcare System in West Haven, Conn.
Dronge's team studied the medical records of 490 diabetes patients. Each patient had gotten noncardiac surgery at the Veterans Affairs Connecticut Healthcare System from January 2000 through September 2003.
A wide range of operations -- including urological, gastrointestinal, vascular (blood vessel), and orthopaedic surgeries -- were covered. Heart procedures weren't included.
Controlling Blood Sugar
Before surgery, the patients had their levels of hemoglobin A1c (HbA1c) measured.
HbA1c gives general information about blood sugar control over the past two or three months. Blood sugar is considered to be under good control if HbA1c levels are less than 7%, according to the American Diabetes Association.
In Dronge's study, a little less than 12% of the patients had HbA1C levels of less than 7%. Those patients were less likely to have pneumoniapneumonia, wound infections, urinary tract infections, or sepsis (a blood infection) after surgery, the study shows.
The researchers adjusted for other factors that could have affected the risk of postsurgical infection. For instance, infection rates after surgery were higher for patients older than 71 years, those who got lengthy operations, and those with unclean wounds before surgery.
Better blood sugar control before surgery usually means better control immediately after surgery, which means less risk for a variety of complications including infections and death. It's not clear if good blood sugar control is a marker of better overall health, the researchers note.
The participants were mainly nonblack men who were about 71 years old, on average. The findings may not apply to other groups, write Dronge and colleagues.