| Objective To analyze the circumstances of information-based blood glucose management on the blood glucose control of type 2 diabetes mellitus(T2DM)patients in orthopaedic perioperative period,the influencing factors of adverse events,and the correlation between blood glucose level and the prognosis of orthopaedic surgery.So as to promote the information-based blood glucose management mode and provide guidance for perioperative blood glucose management of diabetes patients.Methods 204 perioperative patients treated in the Department of orthopedics of Ningxia Medical University General Hospital with T2 DM from January to December 2022 were divided into two groups according to the random number table method,with 102 cases each.Control group implement routine blood glucose management(department self-management or consultation management),test group implement information blood glucose management(collect clinical information by the liaison,blood glucose changes and bedside education,the blood glucose feedback to endocrine doctor,by remote view the data in the hospital Internet system in the platform and guide treatment,then feedback to the patient’s department for execution).Statistical analysis was performed using the SPSS25.0 software.Results1.There was no significant difference between the two groups in the general data comparison(p> 0.05).2.The level of fasting blood glucose in the test group decreased at the time of discharge,the rate of reaching the standard of fasting blood glucose,the detection rate of glycosylated hemoglobin and the number of daily blood glucose detection percapita in the test group were higher than those in the control group(p <0.05).The incidence of severe hyperglycemia,incidence of significant hypoglycemia,the maximum blood glucose fluctuation,postoperative complication rate and hospitalization days were lower than those in the control group(p <0.05).Patients with disc herniation spent less hospitalized than controls(p <0.05).There was no statistically significant difference in the incidence of hypoglycemia and other types of hospitalization costs between the two groups(p> 0.05).3.Multivariate regression analysis:Patients in the test group were taken as the study subjects: high fasting blood glucose at admission increased the risk of serious hyperglycemia events and increased the maximum blood glucose fluctuation;The longer the duration of diabetes and the duration of surgery,the maximum fluctuation of blood glucose is increased;Chronic complications of coronary heart disease and diabetes mellitus prolong the preoperative preparation time;Maximum blood glucose fluctuation ambassador increased risk of severe hyperglycemia;Young age,excessive hypoglycemia during hospitalization,increase the risk of severe hyperglycemia;Long preoperative preparation time,hypoglycemia,and longer hospitalization time for patients with newly diagnosed diabetes;Age,female gender,and coinfection at admission were risk factors for postoperative non-infectious complications.In all study populations,BMI is a protective factor for hypoglycemia;The incidence of hypoglycemia also varies at different BMI levels.The higher the BMI,the lower the incidence of hypoglycemia(p <0.05).4.Mapping the ROC curve found that fasting glucose at admission had early predictive value for severe hyperglycemia,with an AUC of 0.848,cut-off value of 9.65mmol/L,sensitivity of 80% and specificity of 84%.Conclusion1.Compared with conventional blood glucose management,information-based blood glucose management can effectively reduce the incidence of abnormal blood glucose events,postoperative complications and hospital days.and improve the blood glucose compliance rate of T2 DM patients in orthopedic perioperative period,not increase the hypoglycemia.2.Fasting blood glucose at admission,diabetes duration,and operation duration were independent risk factors for the maximum blood glucose fluctuation range;combined coronary heart disease and and chronic complications of diabetes were independent factors influencing the preoperative preparation time;preoperative preparation time,hypoglycemia,and newly diagnosed diabetes were independent factors for hospitalization duration;age,female,and co-infection at admission were independent risk factors for non-infectious complications;age,maximum blood glucose fluctuation,admission fasting glucose,and hypoglycemia were independent risk factors for severe hyperglycemia;and BMI was independent risk factors for hypoglycemia.3.Fasting blood glucose levels at admission had a strong predictive efficacy for the occurrence of severe hyperglycemia during hospitalization. |
PDF Full Text Request