Perioperative Glycemic and Hemodynamic Changes in Diabetic Patients Undergoing Orthopedic Surgery: A Prospective Observational Study in Iraq
Keywords:
Diabetes mellitus; Orthopedic surgery; Perioperative hyperglycemia; Blood pressure; AnesthesiaAbstract
Background:
Perioperative hyperglycemia and blood pressure instability are common among patients with diabetes mellitus undergoing orthopedic surgery and are associated with increased postoperative morbidity. Anesthetic techniques and surgical stress responses may significantly influence metabolic and hemodynamic parameters. This study aimed to evaluate perioperative changes in blood glucose and blood pressure among diabetic patients undergoing orthopedic procedures.
Methods:
A prospective observational hospital-based study was conducted between November 2024 and April 2025, including 184 diabetic patients undergoing orthopedic surgery. Blood glucose and blood pressure were measured preoperatively and postoperatively. Sociodemographic, clinical, and operative variables were recorded. Associations between preoperative and postoperative parameters were analyzed using chi-square tests, with statistical significance set at p ≤ 0.05.
Results:
A significant association was observed between preoperative and postoperative glucose levels (p < 0.001). Notably, 50% of patients with normal preoperative glucose developed postoperative hyperglycemia. Patients with preoperative hyperglycemia remained hyperglycemic postoperatively (100%). Significant associations were also found between preoperative and postoperative systolic and diastolic blood pressure (p ≤ 0.001), with pre-existing hypertension strongly predicting postoperative hypertension. Most surgeries were elective and of moderate complexity.
Conclusion:
Orthopedic surgery in diabetic patients is associated with significant perioperative glycemic and blood pressure fluctuations. These findings emphasize the need for strict perioperative metabolic and hemodynamic monitoring to reduce postoperative complications. Further analytical studies are recommended to determine independent predictors of adverse outcomes.
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