Effect of a program to control perioperative blood glucose on the incidence of nosocomial infections in patients with diabetes: A pilot study

Javier Ena, Rosa Casañ, Maria José Carratalá, Edith Leutscher

Department of Internal Medicine, Hospital Marina Baixa, Alicante, Spain.
Division of Endocrinology and Metabolism, Hospital Marina Baixa, Alicante, Spain.
Division of Preventive Medicine, Hospital Marina Baixa, Alicante, Spain.

DOI: 10.4236/jdm.2012.22038                

Abstract

Aim: To evaluate the safety and effectiveness of a pilot program to control perioperative blood glucose in patients with diabetes. Methods: A pre-post intervention study was conducted in a 280-bed hospital in Spain. In the year 2008 we implemented perioperative insulin protocols aimed at blood glucose values from 80 to 180 mg/dL. Surgical patients with diabetes admitted on year 2009 (intervention group) were compared with a control group of patients with diabetes admitted for surgery on year 2007, matched 1:1 by traditional wound class. Results: We analyzed 96 patients. Implemented protocols were followed in 48% of patients intra-operatively and 75% of patients postoperatively. Patients in the intervention group had reductions in blood glucose at surgery 150 +/- 61 mg/dL vs. 172 +/- 53 mg/dL; p = 0.05), greater proportion of target glucose values throughout hospitalization (67% vs. 55%; p = 0.07), and reductions in the incidence of nosocomial infections after controlling for confounders (Odds Ratio: 0.20; 95% Confidence intervals: 0.06 - 0.72; p = 0.014) when they were compared with the control group: The incidence of hypoglycemia was similar between two groups (0.12% vs. 0.10%, p = 0.867), respectively. Conclusion: Although our protocol needs improvements to increase implementation it was useful to control blood glucose safely and for reducing nosocomial infections.

Keywords

Diabetes; Insulin/Administration and Dosage/Therapeutic Use; Surgical Site Infection; Nosocomial Infection

Conflicts of Interest

The authors declare no conflicts of interest.

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