Abstract
The objective of this study was to evaluate current practice in the management of glycaemia in patients with diabetes undergoing elective surgical procedures in a single renal unit. We performed an audit of the hospital records of 83 patients undergoing elective surgical procedures at a regional renal unit between January and March 2011. Of these patients 22 had diabetes: four with type 1 diabetes and 18 with type 2 diabetes. During their hospitalisation, glucose control was suboptimal with good diabetic days accounting for 52% of the hospital admission. There was over-reliance on variable rate intravenous insulin, which was prescribed in 59% of patients, of which the majority were deemed inappropriate. Prescription errors were more common when insulin was used, with 67% of prescription charts having at least one dose of insulin omitted or not signed. Oral agents were prescribed and administered accurately in 87% of patients. A hypoglycaemic event was experienced by 22% of patients. In conclusion, patients with diabetes and chronic kidney disease are at risk of suboptimal glycaemic management during hospitalisation for elective surgery. These findings have led to improved pre-operative planning, blood glucose management protocols and targeted education programmes.
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