Since the incidence of diabetes in general population has been increased and their life spans prolonged, surgeons will see more diabetic patients in their daily practice. It is conceivable that diabetic patients have more risk than non-diabetic when they are operated upon.
The purpose of this paper is to review diabstics undregoing surgery and clarify differences, if any, between non-diabetic surgical patients.
There were 100 surgical patients with diabetes who were admitted and treated in Yonsei Medical Center during the period between January 1970 to December 1977 for 8 years.
The age distribution was peak in 6th decade and sex ratio was almost same.
Sixty one cases of the 100 subjects in this study had past history and 42 cases of them have been controlled with oral hypoglycemic agents.
On the classification of the diabetic patients by stage, overt diabetes was 62 cases, chemical 35 cases, latent 3 cases.
On admission, the blood glucose level was above 200 mg% in 45 patients and below 100 mg% in 5 cases.
Preoperative management was performed in 65 out of the 85 patients who had elective surgery with insulin for 3-4 days.
But no preoperative treatment was done exeept diet control in 15 cases.
The controlled blood sugar level was 177 mg% in average.
Although the chemical or latent diabetic patients did not need special disbetic control, the overt diabetes demanded to be managed with insulin for higher glucose value in blood.
Preoperative complications were developed in 10 patients.
Seven cases of them developed main wound infection, and two cases had transient hypoglycemic episodes.
Mortality rate was 2 percent.
These results are quite acceptable numbers comparing with non-diabetic patients. It is, therefore, emphasized that careful monitoring of diabetes and judicious management in the pre and postoperative period are the most important.