As an anesthesiologist and also perioperative management, is more concerned with the level of blood sugar at the time or during perioperative time. If that time level is ok, then, will it have an effect in management by knowing the last three months status (even if it was poorly controlled)?
yes , it will have an effect on the surgical outcome if it is poorly controlled . Risk of wound infection is increased , so the trend of blood sugar measurements and HbA1 C are important
Thank you very much. Indeed hyperglycemia is important factor to play a role in tissue / injury healing. But my question is if the patient has blood sugar < 180mg% (when presented for surgery), and on treatment, Is knowing his/her past 3 months glycemic control (by doing HbA1c) going to change any management in perioperative period as in perioperative period too our target of glycemia control is below 180mg% (with few exceptions). What if HbA1c comes high: postponing case? Further control? (already under 180 mg% now). Or what? Or we should not ask for HbA1c blindly?
Fructosamine is yet to be used routinely even for management of diabetes except for few conditions. However, using Fructosamine instead of HbA1c will not serve any extra purpose in perioperative period. In perioperative period we are mostly concerned about the acute changes in the blood sugar / blood sugar level at that time. So, I am still searching the relevance of the test (HbA1c) to decide on acute management during perioperative period.
We found HbA1c a useful screening tool (routine) in diabetics during elective surgical procedures in our centre.
Dear Olusola Akinmola
How you re using it? Do you postpone a case posted for elective surgery who is having an acceptable RBS (below 200mg%) but HbA1c is high?
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