Perioperative glycaemic control in diabetic patients undergoing cataract surgery under local anaesthesia: a survey of practices of Singapore ophthalmologists and anaesthesiologists

Singapore Medical Journal
Jyh Haur WooChandra Mohan Kumar

Abstract

Perioperative glycaemic control is an important aspect of clinical management in diabetic patients undergoing cataract surgery under local anaesthesia. While poor long-term glycaemic control has significant implications for surgery, perioperative hypoglycaemia or hyperglycaemia may also compromise patient safety and surgical outcomes. We aimed to survey ophthalmologists and anaesthesiologists on their approach and to identify the prevalent practice patterns in Singapore. This was a cross-sectional questionnaire-based survey conducted in four public hospitals in Singapore with established ophthalmology and anaesthesia units. Respondents were approached individually, and the self-administered questionnaires comprised questions related to practice patterns, clinical scenarios and awareness of pre-existing guidelines. A total of 129 doctors responded to the questionnaire survey. 76 (58.9%) were from ophthalmology departments and 53 (41.1%) were from anaesthesia departments. The majority chose to withhold oral hypoglycaemic agents (82.9%) and/or insulin (69.8%), and keep the patient fasted preoperatively. A blood glucose level ≥ 17 mmol/L prompted 86.0%-93.8% of respondents to adopt a treat-and-defer strategy, while a level ≥ 23 mmo...Continue Reading

References

Mar 1, 1982·The American Journal of Medicine·E J RayfieldH Smith
Aug 28, 1998·Journal of Cataract and Refractive Surgery·A Zaczek, C Zetterström
Dec 25, 2007·Revista latino-americana de enfermagem·Márcia Galan PerrocaSolange Diná Facundin
Aug 30, 2008·Diabetes Care·V Swetha E JeganathanTien Yin Wong
May 21, 2009·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Etie S MoghissiUNKNOWN American Diabetes Association
Nov 3, 2009·European Journal of Ophthalmology·Mahfouth BamashmusReem Al-Kershy
Apr 2, 2013·Journal of Cataract and Refractive Surgery·Yoshihiro TakamuraMasaru Inatani
Nov 20, 2013·Ophthalmology·Gary C BrownPhilip A Lieske
Dec 18, 2013·Investigative Ophthalmology & Visual Science·Gerard A Lutty

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Citations

May 30, 2019·Journal of Clinical Medicine·Andrzej GrzybowskiRaimo Tuuminen
Dec 31, 2021·Current Diabetes Reports·Jonathan A GoSumitra S Khandelwal

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