Peri-operative practices by Anaesthetists when managing patients with diabetes mellitus at the University of the Witwatersrand Academic hospitals

Abstract

Background: Diabetic patients are frequently encountered in theatre by anaesthetists. These patients are at an increased risk of developing peri-operative complications. The aim of this study was to describe the knowledge of peri-operative diabetic management guidelines as well as peri-operative practices of anaesthetists in the Department of Anaesthesiology at the University of the Witwatersrand (Wits). Methods: A prospective, descriptive, and contextual study was conducted using a self-administered questionnaire developed following review of the literature. The study population consisted of anaesthetists working in the Department of Anaesthesiology at Wits. A convenient sampling method was used and completion of the questionnaire implied consent. Results: In terms of international peri-operative DM guidelines, only 57 (48.3%) knew about them, even fewer 43 (38.1%) reported implementing them, and only 10 (8.6%) had received training on their use. Despite the poor awareness of these international guidelines, majority of participants’ adhered to starvation and fluid management practices as outlined in these guidelines. However, there was inadequate adherence to recommended practices with respect to peri-operative management of oral hypoglycaemic agents. Conclusion: Most Wits Anaesthetists lack knowledge of peri-operative DM guidelines. Despite this, many did comply with international DM guidelines in terms of starvation and fluid recommendations. However, majority demonstrated poor knowledge of recommended practices with respect to management of oral hypoglycaemic agents. There is a need to improve this knowledge by providing more teaching and assessment.