| The prevalence of undiagnosed diabetes in non-cardiac surgery patients, an observational study. | |
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MedLine Citation:
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PMID: 20922587 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Given that preoperative hyperglycemia is associated with poor outcomes and many non-diabetic patients have high plasma glucose (PG) levels, the purpose of our study was to estimate the prevalence of undiagnosed diabetes among non-cardiac surgery patients and to identify predictors of hyperglycemia in non-diabetics. METHODS: We included all non-cardiac surgery patients with complete records in the Clinical Database of the Anesthesiology Institute at the Cleveland Clinic during January 2007 to April 2009, and we estimated the prevalence of undiagnosed diabetes and impaired fasting glucose (IFG) among the non-diabetic patients. The mean glucose levels for known diabetics and undiagnosed diabetics were compared using two-tailed Student's t tests, and we assessed the association between PG levels and demographic variables within the non-diabetics. RESULTS: Of the 39,434 patients analyzed, 5,511 (14%) were known diabetics. Of the 33,923 known non-diabetics, 3,426 (10 %) were undiagnosed diabetics and another 3,549 (11%) had IFG. Thus, 6,975 patients (21%) of the non-diabetic patients presented with abnormally high glucose. Previously undiagnosed diabetics had higher preoperative glucose levels compared with known diabetics, with a mean ± standard deviation (SD) of 161 ± 48 vs 146 ± 67 mg·dL⁻¹ (8.9 ± 2.7 vs 8.1 ± 3.7 mmoL·L⁻¹), respectively. The difference remained highly significant after adjusting for body mass index, age, sex, and American Society of Anesthesiologists (ASA) physical status (P < 0.001). Among non-diabetics, older age, obesity, male sex, and a higher ASA physical status were collectively significant predictors of hyperglycemia, with a c-statistic (95% confidence interval) of 0.67 (0.66-0.68). CONCLUSION: A significant proportion of non-cardiac surgery patients have previously undiagnosed diabetes and pre-diabetes. Previously undiagnosed patients have higher fasting glucose levels compared with diabetic patients. Further studies should be conducted to identify the implications of these findings on patient outcomes. |
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Authors:
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Basem Abdelmalak; Joseph B Abdelmalak; Justin Knittel; Eric Christiansen; Edward Mascha; Robert Zimmerman; Maged Argalious; Joseph Foss |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-05 |
Journal Detail:
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Title: Canadian journal of anaesthesia = Journal canadien d'anesthésie Volume: 57 ISSN: 1496-8975 ISO Abbreviation: Can J Anaesth Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-22 Completed Date: 2011-03-07 Revised Date: 2011-07-05 |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: United States |
Other Details:
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Languages: eng Pagination: 1058-64 Citation Subset: IM |
Affiliation:
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Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, OH 44195, USA. abdelmb@ccf.org |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Blood Glucose / metabolism* Databases, Factual Diabetes Mellitus / diagnosis*, epidemiology Fasting Female Humans Hyperglycemia / diagnosis*, epidemiology Male Middle Aged Obesity / complications Preoperative Care Prevalence Retrospective Studies Risk Factors Sex Factors Surgical Procedures, Operative / adverse effects, statistics & numerical data |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose |
| Comments/Corrections | |
Comment In:
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Can J Anaesth. 2011 Jun;58(6):582-3; author reply 583
[PMID:
21541806
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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