Preoperative glycemic optimization targeting HbA1c below 8% is recommended to reduce postoperative mortality and complications, with HbA1c >8% associated with increased odds of in-hospital mortality (OR 1.40) and major adverse events (HR 2.25).
This joint position statement provides evidence-based recommendations for managing perioperative hyperglycemia to reduce postoperative complications, infections, and in-hospital mortality.
Hospital hyperglycemia, whether or not diabetes has been previously diagnosed, increases the risk of postoperative complications, particularly infections, prolonged hospital stay, and in-hospital mortality. Ensuring adequate glycemic control during the perioperative period helps reduce these risks and improve surgical outcomes. This guideline was developed by the Department of Acute Complications and Inpatient Glycemic Control of the Brazilian Diabetes Society (SBD), in collaboration with representatives from the Brazilian Society of Anesthesiology (SBA), the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), and the SBD Scientific Committee. Key clinical questions guided a narrative review of the literature using MEDLINE via PubMed, including evidence from randomized clinical trials (RCTs), meta-analyses, and high-quality observational studies. The expert group produced 19 recommendations and 20 key notes addressing screening, glycemic targets, management of oral and injectable agents, insulin strategies, and prevention of perioperative complications. Based on the best available evidence, this joint statement provides practical and effective guidance for managing perioperative hyperglycemia across different levels of healthcare.
Marino et al. (Fri,) conducted a other in Patients undergoing elective or emergency surgery with or without prior diagnosis of diabetes mellitus at risk for perioperative hyperglycemia. Preoperative glycemic control optimization and perioperative hyperglycemia screening and management vs. Usual care or no preoperative glycemic optimization was evaluated on Postoperative complications including infection, in-hospital mortality, length of hospital stay, major adverse cardiovascular events. Preoperative glycemic optimization targeting HbA1c below 8% is recommended to reduce postoperative mortality and complications, with HbA1c >8% associated with increased odds of in-hospital mortality (OR 1.40) and major adverse events (HR 2.25).