Effectiveness of preoperative hospitalization for glycemic control in patients with diabetes undergoing gastric or colorectal cancer surgery.

BACKGROUND

This study aimed to investigate the effectiveness of preoperative hospitalization for glycemic control in patients with type 2 diabetes mellitus who underwent surgery for gastric or colorectal cancer.

METHODS

This multi-institutional retrospective cohort study used data from patients who underwent gastric or colorectal cancer surgery between January 2018 and December 2020 at 14 institutions. This study compared the outcomes between patients who were hospitalized for glycemic control before surgery (hospitalized group) and those who were not hospitalized (nonhospitalized group). The primary outcome was postoperative infectious complications of Clavien-Dindo (CD) grade ≥ I, and the secondary outcomes included overall postoperative complications of CD grade ≥ II, perioperative mean blood glucose level per day, and perioperative mean insulin usage per day.

RESULTS

A total of 376 patients with type 2 diabetes mellitus were included, of whom 153 were hospitalized for glycemic control before surgery. Inpatient treatment for glycemic control did not significantly reduce the incidence of postoperative infectious complications (odds ratio [OR], 0.79 [95% CI, 0.39-1.60]; P =.518) and the overall postoperative complications (OR, 1.05 [95% CI, 0.55-2.00]; P =.875). The mean blood glucose levels were not significantly different between the hospitalized and nonhospitalized groups (postoperative day [POD] 1: P =.088; POD0: P =.602; POD1: P =.169; POD2: P =.500; POD3: P =.478). Postoperative insulin usage per day was significantly higher in the hospitalized group than in the nonhospitalized group (POD0: P <.001; POD1: P <.001; POD2: P <.001; POD3: P <.001).

CONCLUSION

This multi-institutional retrospective cohort study was not able to demonstrate the effectiveness of hospitalization for preoperative glycemic control in patients with diabetes mellitus who underwent gastric or colorectal cancer surgery.