P918 - PREVALENCE OF KNOWN AND UNDIAGNOSED DIABETES IN PATIENTS UNDERGOING GASTROINTESTINAL SURGERY.

P918

PREVALENCE OF KNOWN AND UNDIAGNOSED DIABETES IN PATIENTS UNDERGOING GASTROINTESTINAL SURGERY.

A. Adiamah^1,*, T. G. Wong¹, S. Quraishi¹, D. Evans², A. Banerjea¹, D. N. Lobo¹ on behalf of The Nottingham University Hospitals HBA1c Working Group

¹Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen’s Medical Centre, ²Anaesthesia, Nottingham University Hospitals and University of Nottingham, Queen’s Medical Centre, Nottingham, United Kingdom

Rationale: Diabetes mellitus affects an estimated 8.2% of the UK population, with approximately 30% (equating to 1 million individuals) remaining undiagnosed. Notably, patients with diabetes account for 15% of all surgical procedures, and up to 50% of individuals with diabetes require surgery during their lifetime. This study aimed to define the prevalence of undiagnosed diabetes and pre-diabetes in patients undergoing gastrointestinal surgery.

Methods: This prospective observational study was conducted between 1 September 2022 and 1 September 2023. Patients undergoing gastrointestinal surgery who had a perioperative glycated haemoglobin (HbA1c) measurement were included. The proportion of patients with known diabetes, undiagnosed diabetes, and prediabetes were assessed for each surgical category Minor, Intermediate, Major, and Complex major surgery.

Results: Of the 1901 patients undergoing gastrointestinal surgery, the proportion with known diabetes by surgical complexity were: Minor surgery: 90/358 (25%); Intermediate:102/510 (20%); Major:131/810 (16.2%); and Complex major surgery: 39/223 (17.5%). Among patients without a prior diagnosis of diabetes, 72/1539 (4.7%) had HbA1c concentration of 42–47 mmol/mol, meeting criteria for prediabetes. A further 36/1539 (2.3%) had HbA1c ≥48 mmol/mol, meeting diagnostic criteria for type 2 diabetes. Importantly, 8 of the 107 patients (7.5%) with HbA1c levels exceeding the recommended threshold for planned surgery had previously undiagnosed diabetes.

Conclusion: In this large cohort, 1 in 5 patients undergoing gastrointestinal surgery had diabetes. An additional 7% of patients without a prior history of diabetes met biochemical criteria for prediabetes or diabetes. Opportunistic HbA1c testing identified patients with poorly controlled known diabetes and facilitated early diagnosis of unknown diabetes, potentially improving perioperative management and longer-term health outcomes.

Disclosure of Interest: None declared