Endocrine Abstracts

Background: Diabetes mellitus (DM) affects nearly is reported to be present in approximately 8% of cases of elective hip arthroplasty and an HBA1c >53 mmol/mol may be associated with poorer outcomes in these cases.

Aims: To understand the demographics of DM patients in Glasgow undergoing elective hip arthroplasty over a 6 year period between Jan 2009 and Dec 2015 and the rate of post-operative complications.

Methods: Patients were identified through linking the hip arthroplasty patient list with the Scottish Care Information Diabetes dataset. Data were obtained through case note review and electronic patient records.

Results: Of the 2316 patients who had an elective hip arthroplasty at a single tertiary hospital, 102 (4.4%) patients had diabetes. Of these, 100 (98%) had Type 2 DM and 43 (42%) were diet controlled, 55 (54%) used oral antidiabetics and 4 (4%) required insulin. Median age was 71 years (range 39–88 years) and 60 (59%) were female. 16 (16%) were current smokers and 7 (0.1%) drank more than 10 units of alcohol per week. Median ASA (American Society of Anaesthesiologists) score was 2 (2.4) and median Scottish Index of Multiple Deprivation decile was 4 (1.10). Of the 70 cases where an HbA1c was available, HbA1c was >53 mmol/mol in 33 (47%) pre-operatively and >58 mmol/mol in 21 (30%). Five patients suffered early post-operative complications (1 with delirium, 2 with surgical site infections, 1 with acute renal failure and 1 with both a myocardial infarction and a lower respiratory tract infection). HbA1c was >53 mmol/mol in 4/5 of these cases (58, 55, 51, 59 and 54 respectively).

Discussion: The prevalence of DM is comparable to that of DM in the general population. Diabetic control in the current cohort was sub-optimal in half of the cases. The post-operative complication rate was low but was more common in those with sub-optimal control.