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Improved postoperative blood glucose control through implementation of clinical pharmacist driven glycemic management model after colorectal surgery.

Nathan T. Smith,Somboun Xiong,Whitney J. Bergquist,Leah R. Blader,K. Tang,R. Cima

Published 2022 in American Journal of Surgery

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.

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