Background and Goal of Study:
10-15% of surgical patients are diabetic and, as such, it is common to observe higher complication rates,mortality and longer hospital stay1. The management of blood sugars in the preoperative period is fundamental in ensuring a safe surgical journey for these patients. Moreover, deranged bloods sugars are associated with post-operative infections and intraoperative adverse events. In many hospitals, the
management of these patients preoperatively is dependent on junior doctors. However, research has shown that there is variability in the compliance to the latest guidelines which can lead to sub-optimal management2.

The aim of this survey was to determine the level of familiarity of junior doctors at Queens Hospital,Burton,UK on the latest national guidelines in the management of diabetic patients preoperatively3.

Method:
We employed a 10-part survey to explore junior doctors’ current practice and knowledge baseon perioperative glycaemic control.

Results:
34 foundation year doctors took part in this study. Of these, 20% had training in preoperative blood sugar management in the previous year; 41% could identify the correct ideal blood glucose range; 21% of respondents knew how to adjust a patient’s current antidiabetic medication regime preoperatively; 74% of participants could recognise when to start a variable rate intravenous insulin infusion; and 58%
knew to check blood sugar levels hourly while the patient is fasted.

Conclusion:

It is essential that diabetic patients are adequately optimised for surgery to avoid pre, intra and postoperative complications, each of which can have lasting and deleterious effects for patients and the heath service. However, our junior doctors appear inadequately trained in this discipline and are not aware of the latest guidelines. This survey has highlighted that there is a need to introduce preoperative
blood sugar management into the junior doctors’ induction curriculum and provide them with more support when managing these patients.

References:
1. Prevalence and clinical outcome of hyperglycaemia in the perioperative period in noncardiac surgery. Diabetes Care 2010;33:1783-8
2. Jackson M. J, et al; Perioperative management of diabetes in elective patients: a region-wide audit, BJA: 2016:Volume 116,Issue 4,501–506
3.Dhatariya K, et al; NHS Diabetes Guideline for the perioperative management of the adult patient withdiabetes. Diabet. Med. London: Blackwell Publishing Ltd;2012.420-33

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