Poor management of diabetes can have a serious impact on surgical outcomes, increasing the risk of complications and mortality. Discussions are underway to scale up a pilot programme, with the aim of transforming surgical pathways, to help reduce complications and reduce length of stay.
In 2020, a Getting it Right First Time (GIRFT) national report1 highlighted that up to 20% of all hospital beds in England are occupied by people with diabetes, although most (92%) are admitted for other conditions and illnesses. Around 330,000 surgical procedures are carried out on people with diabetes in the UK annually, and their length of stay (LoS) in hospital is, on average, three days longer than patients without diabetes (four days for those admitted as an emergency). Based on these figures, it is estimated that surgery on patients with diabetes accounts for 15% of all operations – so how can we improve outcomes for this significant cohort of patients?
A number of reports have highlighted the need to improve the management of diabetes for patients undergoing surgery, in recent years. Patients with poorly managed diabetes have higher rates of complications post surgery – as well as longer hospital stays – but some healthcare providers fail to get the basics right when it comes to optimising and monitoring diabetes
Throughout the surgical pathway, missed opportunities, avoidable errors and poor communication can result in increased risk of: surgical site infection, poor wound healing, hospital-acquired diabetic ketoacidosis, postoperative sepsis, endothelial dysfunction and cerebral ischaemia.2-8 Furthermore, patients with poorly managed diabetes are known to have a significantly lower survival rate postoperatively.2,3
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