Clinical Profile and Perioperative Glycaemic Management of Adults with Type 2 Diabetes Mellitus Undergoing Elective Surgery

Abstract

Background: Type 2 diabetes mellitus is associated with increased perioperative morbidity due to stress-induced hyperglycaemia, impaired wound healing, and higher risk of postoperative complications. Optimal perioperative glycaemic management is essential to improve surgical outcomes, yet evidence from Indian clinical settings remains limited. This study evaluated the clinical profile, perioperative glycaemic management practices, and postoperative outcomes among adults with T2DM (Type 2 Diabetes Mellitus) undergoing elective surgery.

Methods: A hospital-based cross-sectional study was conducted at SSIMS & RC, Davangere, from January 2023 to December 2023. One hundred adults aged 18–75 years with T2DM (ASA Grade II–III) undergoing elective surgery were enrolled after ethical approval and informed consent. Preoperative demographic, clinical, biochemical, and glycaemic parameters were recorded. Intraoperative monitoring included haemodynamic variables, anaesthetic technique, intravenous fluids, and blood glucose levels. Postoperative outcomes such as ICU admission, hypoglycaemia, DKA (Diabetic Ketoacidosis), surgical site infection (SSI), and duration of hospital stay were assessed. Data were analysed using SPSS version 20 with appropriate statistical tests.

Results: Among 100 participants, 61% were females and 29% were aged above 60 years. The mean HbA1c was 8.04%, mean fasting blood glucose was 136.6 mg/dL, and mean preoperative glucose was 169.02 mg/dL. General anaesthesia was the most common technique (48%). Haemodynamic parameters remained stable throughout surgery. No cases of intraoperative hypotension, myocardial infarction, renal failure, or stroke were reported. ICU admission was required in 50% of patients, predominantly for one day. DKA occurred in 3%, hypoglycaemic episodes in 2%, and SSI in 13% of patients. Overall, favourable perioperative outcomes were observed with appropriate glycaemic and anaesthetic management.

Conclusion: Careful perioperative glycaemic control combined with appropriate anaesthetic management is associated with favourable surgical outcomes and a low incidence of major complications in adults with T2DM undergoing elective surgery. Larger multicentre prospective studies are warranted to validate these findings and optimize perioperative management strategies.