Highlights
- •Pharmacist driven glycemic management improves glycemic control after surgery.
- •Observed tighter glycemic control without increased rates of hypoglycemia.
- •Reducing workload for surgeons through expansion of the postoperative team.
Abstract
Background
Poor postoperative glycemic control has been linked with higher mortality, cardiovascular
complications, stroke, infection, impaired wound healing, and increased length of
stay.
Methods
This multicenter, retrospective study of colorectal surgery patients with Type 2 Diabetes
Mellitus evaluated the difference in mean blood glucose levels postoperatively in
a pharmacist driven glycemic management model vs standard of care. Secondary objectives
assessed hyperglycemic events, severe hyperglycemia, hypoglycemia, postoperative infection,
and rates of endocrinology consults.
Results
186 patients were included, 120 in the pharmacist driven cohort and 66 in the standard
of care. The pharmacist managed cohort demonstrated significantly lower mean blood
glucose (133.9 vs 148.3 mg/dL, 95% CI [-17 to −11] p < 0.001), significantly fewer
hyperglycemic events (9.6% vs 20.5%, p < 0.0001), and non-significant reduction of
hypoglycemic events (0.7% vs 1.2%, p = 0.1443).
Conclusions
Expansion of the postoperative care team by utilizing pharmacists to manage postoperative
blood glucose resulted in improved glycemic control.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: December 26, 2022
Accepted:
December 26,
2022
Received in revised form:
December 13,
2022
Received:
November 4,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
