Wednesday June 19, 2019

Joint Surgery May Spike up Blood Sugar Levels in Diabetics

Haemoglobin A1c above 6.59 for people with insulin-dependent diabetes and 6.6 without the condition was associated with an elevated risk for post-operative hyperglycemia

0
//
Knee Joint. Pixabay.

People with diabetes who undergo joint replacement surgery are at higher risk of experiencing elevated blood sugar levels after the operation, increasing their chances of developing infections and other complications, a new study suggested.

Patients with insulin-dependent diabetes were more than five times as likely as those without the condition to develop hyperglycemia, or high blood sugar, after surgery, said researchers, including Bradford Waddell from the Hospital for Special Surgery (HSS) in the US.

“If your patient comes in with diabetes and is dependent on insulin, you need to be more cognizant of controlling their blood sugar in the perioperative period because they’re at higher risk,” said Waddell.

For the study, presented at the 2019 annual meeting of the American Academy of Orthopaedic Surgeons, the team reviewed medical charts of 773 men and women who had undergone total hip or knee replacement surgeries between 2011 and 2016.

Of those, 437 had insulin-dependent diabetes, while 336 had not the condition. It included patients with a diagnosis of diabetes whose blood sugar was being controlled using the hormone insulin and compared them with diabetics who did not require insulin.

Diabetes
Representational image. Pixabay

Patients requiring insulin can be considered to have more severe diabetes and have a greater chance of experiencing elevated blood glucose in the perioperative period, Waddell said.

Patients with higher blood glucose over the previous three months — as measured by Hemoglobin A1c — were more likely to experience post-operative hyperglycemia regardless of which group they were in.

Also Read- Excessive Hygiene Can Cause Antibiotic Resistance, Says Study

Hemoglobin A1c above 6.59 for people with insulin-dependent diabetes and 6.6 without the condition was associated with an elevated risk for post-operative hyperglycemia.

However, despite the increased risk for elevation in blood sugar after surgery, the incidence of post-operative joint infections did not differ between the two groups of patients. The author also noted that a limitation of the study was that it was underpowered to detect the risk of infection. (IANS)

Next Story

Researchers Find Drug to Delay Type-1 Diabetes by Two Years

The effects of the drug were greatest in the first year after it was given, said the study published online in The New England Journal of Medicine

0
Diabetes
Representational image. Pixabay

In a first, researchers have found that a treatment affecting the immune system effectively slowed the progression to clinical Type-1 diabetes in high risk individuals by two years or more.

“The results have important implications for people, particularly youth, who have relatives with the disease, as these individuals may be at high risk and benefit from early screening and treatment,” said Lisa Spain, Project Scientist from US National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

The study, involving treatment with an anti-CD3 monoclonal antibody (teplizumab), was conducted by Type 1 Diabetes TrialNet, an international collaboration aimed at discovering ways to delay or prevent Type-1 diabetes.

Participants were randomly assigned to either the treatment group, which received a 14-day course of teplizumab, or the control group, which received a placebo.

All participants received glucose tolerance tests regularly until the study was completed, or until they developed clinical Type-1 diabetes – whichever came first.

During the trial, 72 per cent of the people in the control group developed clinical diabetes, compared to only 43 per cent of the teplizumab group.

diabetes
“Although Type-1 and Type-2 diabetes in parents are well-established risk factors for diabetes, we show that gestational diabetes mellitus may be a risk indicator for diabetes in the mother’s children before age 22,” . Pixabay

The median time for people in the control group to develop clinical diabetes was just over 24 months, while those who developed clinical diabetes in the treatment group had a median time of 48 months before progressing to diagnosis.

“The difference in outcomes was striking. This discovery is the first evidence we’ve seen that clinical Type-1 diabetes can be delayed with early preventive treatment,” Spain added.

Type-1 diabetes develops when the immune system’s T cells mistakenly destroy the body’s own insulin-producing beta cells.

Also Read- Cutting Sodium Intake May Prevent 94 Million Premature Deaths From CVD

Insulin is needed to convert glucose into energy. Teplizumab targets T cells to lessen the destruction of beta cells.

The effects of the drug were greatest in the first year after it was given, said the study published online in The New England Journal of Medicine. (IANS)