A Hospital-Wide informatized glycemic management Team(WH-GMT) improves perioperative outcomes in type 2 diabetes: A prospective cohort study.

PURPOSE: To evaluate the effectiveness of the Hospital-Wide Informatized Glycemic Management Team (WH-GMT) model on perioperative outcomes in patients with type 2 diabetes mellitus (T2DM).

METHODS

This prospective cohort study enrolled 360 T2DM patients scheduled for elective surgery. Participants were allocated to a control group (n = 132) receiving standard management or a WH-GMT group (n = 228). Outcomes were compared using multiple regression, mediation, and subgroup analyses.

RESULTS

The WH-GMT group demonstrated a significantly shorter median hospital stay [12.0 vs. 15.0 days, P < 0.001]. Both preoperative Time in Range (TIR) (56.5% vs. 45.5%, P = 0.001) and pre-discharge TIR (63.2% vs. 46.5%, P < 0.001) were significantly higher in the WH-GMT group. Hypoglycemic events (13.2% vs. 31.1%) and adverse events (4.8% vs. 14.4%) were significantly reduced in both cases (P < 0.01). WH-GMT was an independent factor for improved outcomes. Mediation analysis revealed that WH-GMT indirectly reduces adverse events by enhancing preoperative TIR, thereby reducing hospitalization duration. Subgroup analysis revealed the most pronounced benefit in patients with an HbA1c level of ≥ 9.1%, resulting in a 4.08-day reduction in stay (P < 0.001).

CONCLUSION

The WH-GMT model effectively improves glycemic control, reduces complications, and shortens hospital stays for perioperative T2DM patients, with the most significant benefit in those with poor baseline control.