The prevalence of preoperative hyperglycemia among adult surgical patients at the Kenyatta National Hospital

Abstract

Introduction; Hyperglycemia is a condition manifested by an elevated glucose level in circulation and may be caused by several factors including diabetes mellitus or pre-diabetic states, drugs, acute illness and inflammation. Worldwide changes in lifestyle have led to increased rates of diabetes mellitus. While guidelines on glucose testing are lacking, several studies suggest the need for more widespread glucose testing among hospital patients. Objective and methodology ; A hospital based cross-sectional survey was carried out over a period of six weeks to evaluate the prevalence of hyperglycemia , impaired fasting glucose and undiagnosed diabetes among adult patients scheduled for elective surgery. Possible predictors of hyperglycemia in this population were also assessed. An Interviewer administered questionnaire was used in addition to weight, height, and fasting blood sugar measurements. Glycated hemoglobin measurement was also done in selected patients. Results; 163 non-diabetic adult patients who were scheduled to undergo anesthesia and surgical procedures were studied. Subjects were 55.8% female with a mean age of 44.9 ± 14.0 years. 3.7% of the patients were hyperglycemic (FBS > 6.1mmol/l). The prevalence of impaired fasting glucose (FBS 6.1- 6.9mmol/l) was 2.5% while that of undiagnosed diabetes (FBS > 6.1mmol/l and HbA1c ≥ 6.5%) was 1.2% This study revealed a lower prevalence of both preoperative impaired fasting glucose and undiagnosed diabetes relative to estimates from the general population and from similar studies. None of the patient characteristics studied was statistically significant as a predictor of hyperglycemia.