Perioperative Glycemic Control in Patients Undergoing Surgery for Diabetic Foot Ulcers

Open Access

Abstract

Background: Diabetic foot is a serious complication of diabetes, with poor glycemic control increasing the risk of ulcers, gangrene, and amputation. Perioperative hyperglycemia further elevates the risk of postoperative complications, including infection, delayed healing, and higher morbidity. Objective: The aim of the study was to evaluate the impact of perioperative glycemic control on surgical outcomes in patients undergoing surgery for diabetic foot ulcers. Methods & Materials: This observational study was conducted at the Department of Anaesthesia, North Bengal Medical College and Shahid Munsur Ali Medical College. Sirajganj, Bangladesh, from January to December 2024, including 120 patients with diabetic foot ulcers undergoing surgery. Patients were classified by perioperative glycemic control. Demographic, surgical, and postoperative outcome data were collected and analyzed using Fisher’s exact test and independent t-test, with p < 0.05 considered significant. Results: Among 120 patients (mean age 59.9 ± 5.9 years, 65% male), 56.7% achieved good perioperative glycemic control. Minor amputation was the most common procedure (54.2%). Poor glycemic control was associated with higher rates of surgical site infection (36.5% vs 13.2%), delayed wound healing (38.5% vs 17.6%), re-operation (23.1% vs 7.4%), re-amputation (17.3% vs 4.4%), and longer hospital stay (12.7 ± 5.6 vs 8.2 ± 3.1 days; p < 0.001). In-hospital mortality was higher with poor control (11.5% vs 2.9%; p = 0.140). Conclusion: Strict perioperative glycemic control improves surgical outcomes and reduces postoperative complications in patients with diabetic foot ulcers.