Tariq Hayat Khan Habib Md Reazaul Karim Apurb Sharma Anuja U. Abayadeera Md Rabiul Alam

Keywords: HbA1c level, Sugar, Cut-off, Sugar level, Anesthesia, Perioperative practice, Hyperglycemia

Abstract

Background & Objective: Diabetes mellitus is widely prevalent and significantly impacts the perioperative outcome. We aimed to assess the perioperative practice for managing diabetes mellitus patients and variation across different establishments.

Methodology: A questionnaire-based online survey was conducted for the present cross-sectional, multinational study; data collection followed a snowball method and was conducted from November 2020 to January 2021. Responses were presented in absolute number and percentage scale, and response rates among the subgroups were analyzed using Fisher’s exact test; p < 0.05 was considered significant.

Results: Responses from 556 out of 637 from six South Asian Association for Regional Cooperation countries were analyzed. A considerable amount of practice variation was noted; variation increased as the invasiveness of surgery increased. Perioperative insulin administration strategy and case postponement based on blood sugar level differed between the teaching and non-teaching sectors and private and public sectors. However, a majority (64.8%) of the respondents did not favor postponing a case based on the glycosylated hemoglobin (HbA1c) level. Confusion and diverse opinions were present even for emergency cases, including postponement based on blood sugar.

Conclusion: There is a wide variation in the perioperative practice for managing diabetes mellitus patients. The variation increases with the increasing invasiveness of surgery. Although there were similar practices between private versus public sectors and teaching versus non-teaching institutions, significant differences were noticed about case postponement, indicating that an authoritative guideline is the need of the hour.

Key words: HbA1c level; Sugar, Cut-off; Sugar level; Anesthesia; Perioperative practice; Hyperglycemia

Trial Registration: The study was an online survey and as per the clinical trial registry of India, it was not required to be registered.

Citation: Karim HMR, Sharma A, Khan TH, Abayadeera AU, Alam MR. A multinational online survey on the current perioperative practice for the management of patients with diabetes mellitus: a descriptive study. Anaesth. pain intensive care 2022;26(1):382-390. DOI: 10.35975/apic.v26i3.1914

Received: April 27, 2021; Reviewed: October 11, 2021; Accepted: December 16, 2021

 

Author Biographies

Tariq Hayat Khan

Editor-in-Chief and Publisher, Anaesthesia, Pain & Intensive Care, APICAREHQ, Islamabad, Pakistan.

Habib Md Reazaul Karim

 Department of Anesthesiology, Critical Care and Pain Medicine. All India Institute of Medical Sciences, Raipur, India.

Apurb Sharma

Department of Anesthesiology, Pain Management and Critical Care, Nepal Mediciti, Lalitpur, Kathmandu, Nepal.

Anuja U. Abayadeera

Department of Anesthesiology, Faculty of Medicine, University of Colombo, Sri Lanka.

Md Rabiul Alam

Evercare Hospital, Dhaka, Bangladesh.