Gambaran Kadar Gula Darah pada Pasien Pasca Operasi Bedah Mayor Dengan Riwayat Diabetes Melitus Tipe 2: Systematic Review

Abstract

Background: The surgical exacerbate insulin resistance in patients with type 2 diabetes mellitus. This is because surgery can trigger a cell stress response. Excessive stress hormones can reduce insulin sensitivity which causes an increase in blood glucose. Therefore, glucose control in postoperative patients with type 2 diabetes mellitus is necessary to improve surgical outcomes. Objective: This systematic review aims to synthesize existing literature to describe blood sugar levels in type 2 diabetes mellitus in the postoperative period of major surgery. Study design and setting: Using a Systematic Review design and following PRISMA guidelines. Data Source: Using five electronic databases for analysis that focuses on data on blood sugar levels in postoperative diabetes mellitus patients. Review method: data synthesis is carried out by extracting all findings, developing categories, and processing the synthesized findings. Results: Eleven studies were analyzed. The three synthesized findings were summed up: 1) pre-operative blood glucose levels, 2) postoperative blood sugar levels, 3) differences in pre-operative and postoperative blood sugar levels. Postoperative blood sugar levels are influenced by several factors: 1) Presence or absence of complications, 2) Use of different types of insulin, 3) HbA1C levels. Conclusion: The increase in postoperative blood sugar levels is temporary and decreases >24 hours after surgery. Preoperative sugar levels tend to be within the normal range in all patients, but are highest in heart surgery patients. There was an increase in postoperative sugar levels, which was highest in patients with heart surgery with complications which also had the highest difference