Abstract: Objective To investigate the status of perioperative blood glucose management in the elderly patients with diabetes, and to study the correlation between blood glucose control level and prognosis of orthopedic surgery. Methods The level of blood glucose was collected at 5 time-points per day from 2 days before surgery to 3 days after surgery in the elderly patients with type 2 diabetes who underwent orthopedic surgery. The effects of blood glucose levels and blood glucose variations on postoperative complications were analyzed. Results The median HbA1c of 109 patients was 7.3%, and 24 patients (22.02%) presented with HbA1c > 8.5%. The median preoperative peripheral blood glucose was 9.02 mmol/L, and the preoperative peripheral blood glucose coefficient of variation (CV) was 0.28±0.10. There were 14 patients (12.84%) with postoperative complications, including 10 patients (9.17%) with surgical site infection.The incidence of postoperative complications and surgical site infection in the group with a level of preoperative blood glucose >9.02 mmol/L was significantly higher than that in the group with a level of preoperative blood glucose ≤9.02 mmol/L (20.37% vs 5.45%;14.81%vs 3.64%, respectively,all P＜0.05). The incidence of perioperative hypoglycemic events in the group with preoperative CV>0.29 was significantly higher than that in the group with preoperative CV≤0.29 (29.63% vs 9.09 %, P＜0.05). Conclusions The status of perioperative blood glucose management in the elderly patients with diabetes undergoing orthopedic surgery needs to be improved. Strengthening preoperative blood glucose monitoring and management is beneficial to reduce the incidence of orthopedic surgery complications in the elderly diabetic patients.

Key words: aged, diabetes mellitus, blood glucose management, orthopedic surgery, prognosis