Fasting blood glucose levels in patients presenting for elective surgery.
OBJECTIVE
The incidence of diabetes mellitus (DM) is increasing worldwide; however, its diagnosis is often delayed. Identifying patients with abnormal fasting blood glucose (FBG) levels preoperatively may have important implications for immediate and long-term outcomes. The aim of the present study was to determine the prevalence of impaired fasting glucose (IFG) and provisional diagnosis of DM (PDD) with potential risk factors in patients presenting for elective surgery.


METHODS
We measured FBG in consecutive adult patients undergoing elective non-cardiac surgery from September 2006 to August 2007. Patient age, sex, body mass index, and FBG were collected in the morning of their scheduled intervention. FBG was classified according to the World Health Organization categorization. Patients with a history of DM were excluded from the final analysis. The prevalence of IFG and PDD and odds ratio for risk factors were calculated.


RESULTS
Four hundred ninety-three patients without a prior diagnosis of DM were sampled; 19.3% (95 of 493) had IFG and 6.5% (32 of 493) had PDD. Male subjects had a greater risk of PDD than female subjects (odds ratio 2.5, 95% confidence interval 1.2-5.5, P = 0.017). Increased body mass index was not a risk factor for IFG or PDD. The prevalence of IFG but not of PDD had a tendency to increase with age after 40 y.


CONCLUSIONS
More than 25% of patients without a prior diagnosis of DM presenting for elective surgery had increased FBG levels. Obtaining this information may initiate not only an earlier detection of DM in some patients but also affect acute perioperative management and outcomes.
Hatzakorzian
Roupen
R
Department of Anaesthesia, McGill University Health Center, Royal Victoria Hospital, Montreal, Quebec, Canada. roupenhatz@hotmail.com
Bui
Helen
H
Carvalho
George
G
Shan
William Li Pi
WL
Sidhu
Surita
S
Schricker
Thomas
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D017558:Elective Surgical Procedures; D005215:Fasting; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors
D001786:Blood Glucose