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Blood Sugar Control Boosts Diabetics’ Recovery After Surgery

It lowers risks for serious infection, study finds, even though we already knew this was the case. Good blood sugar control before surgery reduces the risk of postoperative infections in people with diabetes, U.S. researchers report.

The study included 490 diabetic patients, average age 71, who had major noncardiac surgery. Their hemoglobin (Hb A1c) levels were measured within 180 days before the surgery. Hb A1c reflects the patient’s control of blood glucose levels during the previous two to three months. Good blood sugar control was defined as an Hb A1c level of less than 7 percent, the American Diabetes Association target.

Of the patients in the study, 197 (40 percent) had good blood sugar control, report researchers at Yale University School of Medicine. Patients who did not have good blood sugar control had higher rates of postoperative infections, such as pneumonia, wound infection, urinary tract infection and sepsis (systemic blood infection).

Postoperative infections were also more common among patients who were older, had higher scores on physical status tests, had wounds classified as "non-clean" or had operations that took longer.

The Yale team suggested two reasons why good blood sugar control before surgery might reduce infection risk. One reason: patients with better blood sugar control before surgery are more likely to have lower blood sugar levels after surgery as well, which has been found to reduce the risk of infection.

"The other possibility for decreased postoperative infection with long-term glucose control is the overall improvement in general health and metabolic milieu of the well-controlled diabetic patient," the study authors wrote.

"If the association is confirmed in other studies, strategies to improve glycemic control prior to elective surgery can be employed to decrease infections and improve overall outcomes for diabetic surgical patients," they said.
April issue of the Archives of Surgery.

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