In a study published in the Journal of Bone and Joint Surgery, it was indicated that diabetics who would undergo total joint replacement are more at risk for complications after surgery due to their pre-existing health conditions. However, the study otherwise claimed that those complications are less likely to occur when a diabetic patient has glucose levels under control. “We found that controlled glucose levels really do make a aifterence for the patient,” said study co-author Dr. Milford Marchant Jr., an orthopedic surgeon who conducted tne study with colleagues of the adult Reconstruction Section at Duke University Medical Center.

Moreover, the study found out that, more than post-surgical complications, uncontrolled glucose levels in patients are three times more likely to experience a stroke or death after joint replacement surgery and twice as likely to experience post-operative bleeding and infection.

Using data from a national healthcare database on more than one million patients who had total joint replacement surgery from 1988 to 2005, Dr. Marchant and his colleagues found out that surgical complications, such as infection, blood transfusions and longer hospitals stays, are more prevalent in patients with uncontrolled glucose levels than those who had controlled glucose levels and those patients who did not have diabetes.

“It did not matter if the patient had Type 1 or Type 2 diabetes,” he explained. “We found that patients had fewer complications after surgery if their glucose level was controlled before, during and after surgery.” He added that the factors necessary for diabetic patients to be considered ‘under control’ are different for each individual patient; therefore diabetic patients should have good relationships with their medical doctors.

As defined by the American Diabetes Association, disease control is determined based on a series of laboratory blood tests and an assessment of diabetes-related illnesses. Approximately only eight percent of patients undergoing total hip and knee replacement in the United States have diabetes. “It is crucial for patients to have controlled glucose level before, during and after surgery because it reduces the potential of having a complication,” Dr. Marchant noted. “This is the responsibility of both the patient and the surgeon, and it should be a priority.”

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