Email this article Glucose metabolism disorders and hypoglycemic therapy in patients hospitalized for elective lower limb arthroplasty: a prospective, single-center, real-world study
- Authors: Okisheva E.A.1, Trushina O.Y.1, Mamaeva M.M.1, Redyanova E.A.1, Zhazhieva A.A.1, Chasova I.D.1, Panferov A.S.1, Bogdanov M.M.1, Lychagin A.V.1, Fomin V.V.1
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Affiliations:
- Sechenov First Moscow State Medical University (Sechenov University)
- Issue: Vol 96, No 7 (2024): VARIO
- Pages: 659-665
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/262135
- DOI: https://doi.org/10.26442/00403660.2024.07.202780
- ID: 262135
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Abstract
Aim. To assess the incidence of glucose metabolism disorders, administered hypoglycemic therapy and its effectiveness in a cohort of patients with previously diagnosed diabetes mellitus (DM) hospitalized for scheduled lower limb joint arthroplasty.
Materials and methods. The study included 502 patients. Medical history, information about previously diagnosed DM and prescribed hypoglycemic therapy were collected in all patients according to medical documentation, as well as according to the patients’ survey. Within the preoperative examination, the glucose level was measured, and in patients with previously diagnosed diabetes, measuremaent of the HbA1c level was recommended.
Results. The study population included 180 (35.9%) males and 322 females (64.1%). Among them, 99 (19.7%) patients had disorders of glucose metabolism [type 1 diabetes – 1 (0.2%) patient, type 2 diabetes – 90 (17.9%) patients, impaired glucose tolerance (IGT) – 8 (1.6%) patients]. In 8 patients, type 2 diabetes was newly diagnosed during the preoperative examination. HbA1c was measured before hospitalization in 26 patients with diabetes, the mean level was 7.0±1.4%. Regarding the analysis of hypoglycemic therapy, almost half of the patients with DM – 47 (47.5%) – received metformin monotherapy, 8 patients with IGT and 8 patients with newly diagnosed DM did not receive any drug therapy. Target glycemic levels during therapy were achieved in 36 (36.4%) patients, and target HbA1c levels were achieved in 21 patients.
Conclusion. The cohort of patients hospitalized for elective lower limb joint arthroplasty is characterized by a relatively high incidence of glucose metabolism disorders, and in some patients, DM was newly diagnosed during the preoperative examination. Metformin is most often used as hypoglycemic therapy, and the target values of glycemia during treatment were achieved in less than half of the patients. The monitoring of the level of glycated hemoglobin is low and requires additional population analysis in order to determine the causes and optimize the strategy of patient management.
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##article.viewOnOriginalSite##About the authors
Elena A. Okisheva
Sechenov First Moscow State Medical University (Sechenov University)
Author for correspondence.
Email: e.okisheva@gmail.com
ORCID iD: 0000-0003-2977-7203
канд. мед. наук, доц. каф. факультетской терапии №1 Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowOlga Yu. Trushina
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0000-0002-5820-1759
д-р мед. наук, проф. каф. факультетской терапии №1 Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowMilana M. Mamaeva
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0009-0004-0811-8756
студентка Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowElena A. Redyanova
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0009-0004-5567-5299
студентка Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowAnna A. Zhazhieva
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0009-0009-1010-5483
студентка Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowIrina D. Chasova
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0009-0003-8385-0341
студентка Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowAlexander S. Panferov
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0000-0002-4324-7615
канд. мед. наук, доц. каф. факультетской терапии №1 Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowMaxim M. Bogdanov
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0000-0001-8603-2510
врач травматолог-ортопед Клиники травматологии, ортопедии и патологии суставов
Russian Federation, MoscowAlexey V. Lychagin
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0000-0002-2202-8149
д-р мед. наук, проф., зав. каф. травматологии, ортопедии и хирургии катастроф Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowVictor V. Fomin
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.okisheva@gmail.com
ORCID iD: 0000-0002-2682-4417
чл.-кор. РАН, д-р мед. наук, проф., проректор по инновационной и клинической деятельности, зав. каф. факультетской терапии №1 Института клинической медицины им. Н.В. Склифосовского
Russian Federation, MoscowReferences
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