Endocrine Abstracts

Patients with diabetes mellitus (DM) are more likely to suffer from purulent infection, probably due to compromised immune response. Achieving target levels of glycemia is a prerequisite for the perioperative management of patients with DM. However, the specific parameters of glycemic variability, optimal glucose range for the effective treatment of purulent infection of the maxillofacial region have not been established yet.

Purpose: to assess the impact of compensation of DM on the perioperative period, the duration of hospitalization in patients with DM and purulent infection of the maxillofacial region.

Materials and methods: 528 patients with DM were examined while undergoing surgical treatment from moderate purulent infection of the maxillofacial region (determined by the severity of intoxication, the extent of the lesion) for 2019-2022: with an average age of 62± 36 (men -245, women -283); duration of DM from 0 to 31 years. Conducted: assessment of the impact of various glycemic parameters on the hospital stay, the perioperative period.

Results: Upon admission, the level of prandial glycemia was 11.03±5.79 mmol/l; postprandial glycemia - 14.37± 6.01 mmol/l, glycemic fluctuations throughout the day 3.54±2.88 mmol/l. After correction of glucose-lowering therapy, prandial glycemia decreased to 8.46±4.33; postprandial decreased up to 11.33±4.57, while glycemic fluctuations during the day were 3.94±2.98. Statistical data processing revealed that the level of post-prandial glycemia during the day has a maximum impact (19%) on the duration of hospital stay. The calculated model is U= 1.5X-8, where U - the days of hospitalization, x- the maximum level of glycemia, (P<0.001). An increase in maximal postprandial glycemia by 1.0 mmol/l prolonges hospital stay by 1,5 days. The prandial levels of glycemia also effect the length of hospital stay by 10% (r2-0.10). Estimated model of days of hospitalization: U= 17-0.6X, where U- the days of hospitalization, x- level of fasting glycemia, the model is calculated with an accuracy of 95%. If maximum level of glycemia during the day is less than 12 mmol/l, the recovery time decreases up to 10 days.

Conclusions: 1) The highest level of glycemia during the day is the most significant parameter affecting the perioperative period. 2) The optimal level of postprandial glycemia throughout the day should be less than 12 mmol/l in patients with DM and purulent infection of the maxillofacial region undergoing surgical treatment. 3) When the level of postprandial glycemia increases by 1 mmol/l, the number of days of hospitalization increases by 1.5.