Key result
Peri-operative diabetes management practices vary significantly across Indian health facilities, particularly for day-care surgery.
Why the study?
The increased burden of diabetes in India and the paucity of national guidelines have led to marked practice variations in peri-operative diabetes management among anesthesiologists.
Cross-Sectional
Yes
This survey highlights significant practice variations and gaps in the peri-operative management of diabetic patients among Indian anesthesiologists.
Marked practice variations across Indian facilities underscore need for national guidelines; leaves open standardization of operative prioritization and day-care eligibility.
Background and Aims: Increased burden of diabetes in India has resulted in a spurt in the number of patients with diabetes posted for surgeries. The paucity of national guidelines can lead to marked practice variations in the peri-operative management of diabetes. This survey intends to discern current peri-operative practices among anesthesiologists working in medical colleges, tertiary care government, and private health care institutes of the country. Material and Methods: An anonymous online survey comprising of 25 closed-ended questions was conducted using Google Forms® and disseminated through social media, emails, and messaging platforms. The questionnaire dealt primarily with the peri-operative management of diabetes in patients scheduled for elective surgery. The survey was conducted over a period of 1 month and targeted anesthesia resident trainees with more than 1-year experience, senior residents, and consultants working in India. Results: Statistically significant difference was observed between the three types of health facilities with respect to prior evaluation for diabetes ( P = 0.007), prioritizing operative list ( P = 0.006), hospital encouragement of day care surgery ( P < 0.001), glycated hemoglobin level (HbA1c) level >8.5 for postponement of surgery ( P < 0.05), insulin infusion preference ( P < 0.001), hourly intra-operatively capillary blood glucose (CBG) assessment ( P = 0.021), and avoiding peri-operative use of Ringer’s lactate (RL) ( P = 0.025). Conclusion: This survey primarily highlights the lack of prioritizing the operative list, early discontinuation of metformin, and reduced tendency to consider diabetics for day care surgeries.
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Priya et al. (2023) conducted a cross-sectional in Diabetes mellitus (peri-operative management). Health facility type (medical college, government, private) was evaluated on Differences in peri-operative practices between health facility types. Significant differences in peri-operative diabetes management practices exist among Indian health facilities, including hospital encouragement of day care surgery (P<0.001).
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