The Effects Of Blood Glucose Management Models On Perioperative Diabetic Patients

Background:The global prevalence of diabetes is increasing in recent years.Diabetes has become one of the most serious and common chronic diseases,which not only affects the quality of life of patients,but also brings high treatment costs,and may even endanger life and shorten life expectancy.The proportion of hospitalized surgical patients with diabetes mellitus is increasing,and poor blood glucose control is considered to be closely related to the incidence of postoperative complications and the prolongation of hospital stay.Therefore,blood glucose management of hospitalized patients is very important.This study explored the effects of different treatment regimens and new Internet blood glucose management mode on perioperative diabetic patients,in order to provide new ideas for blood glucose management in this population.Purpose:This study aims to provide new ideas for blood glucose management in this part of the population,improve the blood glucose compliance rate,correct metabolic disorders,reduce postoperative complications,shorten the length of hospital stay,and improve the quality of life by means of exploring the effects of different treatment schemes and new Internet blood glucose management mode on perioperative diabetic patients.Methods:The research objects were diabetic patients who were admitted to the Department of Surgery of the First Hospital of Jilin University for elective surgery and submitted to the Department of Endocrinology and Metabolism for consultation were collected from July to September 2021 and July to September 2022.The departments surveyed mainly included orthopedics,urology,general surgery,gynecology,ophthalmology,etc.According to the inclusion and exclusion criteria,a total of 376 patients with complete data were finally included as the research objects.Collect basic information: Gender,age,height,weight,History of hypertension,history of diabetes mellitus,history of smoking,history of drinking,Surgical classification grade,Anesthesia grade,Wound healing grade,Postoperative complications,Hospitalization cost,Length of stay,average blood glucose on the first day of hospitalization,average blood glucose on the first day before discharge,short-term glycemic variability indicators(SDBG,MAGE,CVBG),hypoglycemic events and postoperative complications.According to the treatment plan,they were divided into CSII group and MDI group(basal plus postprandial insulin subcutaneous injection).And according to the consultation management mode,they were divided into information management mode group and traditional consultation management mode group.The baseline data,economic and health data,blood glucose characteristics and postoperative complications of the two groups were analyzed.The measurement data was expressed as mean ± standard deviation in normal distribution,and the median(quartile)of non-normal distribution was expressed as median(quartile).The t test or analysis of variance was used for comparison of normal data between groups,the non-normal quantitative data was analyzed by non-parametric rank sum test,and the qualitative data was analyzed by chisquare test.SPSS 25.0 software was used for statistical analysis.A P value of less than0.05 was considered statistically significant.Results:1.The length of postoperative hospital stay and total hospital stay in CSII group were less than those in MDI group(P < 0.05),but there was no significant difference in hospitalization expenses between the two groups(P > 0.05).2.The incidence of postoperative incision infection in CSII group was lower than that in MDI group(P<0.05).There were no significant differences in other postoperative complications and wound healing between the two groups(P > 0.05).3.The average blood glucose on the first day of hospitalization,the difference of blood glucose before and after operation,and the coefficient of variation of blood glucose in CSII group were higher than those in MDI group(P < 0.05).4.The postoperative hospitalization days and total hospitalization days in the information blood glucose management group were less than those in the traditional consultation management group(P < 0.05),and there was no significant difference in hospitalization expenses between the two groups(P > 0.05).5.The mean blood glucose on the day before surgery,the day of surgery,the first postoperative day of the information management group is less than the traditional management model group(P < 0.05);The postoperative mean blood glucose before the breakfast and sleep,and the postoperative mean blood glucose after three meals,lunch and supper in the information management group is lower than the traditional management model group(P < 0.05);The CVBG of the information management group was significantly lower than that of the traditional management group(P < 0.05).6.Preoperative blood glucose level was positively correlated with diabetes course,BMI,HBA1 c and history of malignant tumor in perioperative diabetes patients(P <0.05).Postoperative blood glucose was positively correlated with diabetes course,BMI,HBA1 c,anesthesia grade and operation duration(P < 0.05).Conclusions:1.CSII can shorten the postoperative and total hospital stay,and has no significant effect on hospitalization costs compared with basal insulin combined with subcutaneous insulin injection.2.The possibility of incision infection after continuous subcutaneous insulin infusion is lower than basal insulin combined with subcutaneous bolus insulin.3.CSII is more effective in lowering blood glucose,but with greater blood glucose variability compared with basal and prandial insulin subcutaneous injection.4.The patients have higher glycemic control rate,more stable glycemic fluctuation under the information-based blood glucose management mode.In addition to that,there are shorter postoperative hospital stay and total hospital stay in this new mode.And the incidence of postoperative complications is significantly lower than that of the traditional mode,but there seems to be no significant difference in wound healing.