Arthroplasty Complications Clinical Trial
Official title:
Recognition and Treatment of Dysglycemia in Elective Knee and Hip Arthroplasties. AGS - Acute Glucose Service
AGS (Acute Glucose Service ) is an inpatient glucose management service consisting of Nurse
Practitioner and physician. Team manages not - consulted- based preoperative assessment,
perioperative glucose control, patient education and supervision, but also transition of care
postoperatively. The goal is to detect and treat dysglycemias , but also provide an active
and constantly ongoing education to other hospital teams.
AGS improves better overall- survival of arthroplastic patients and is an effective way to
recognize and treat dysglycemias and to organize constantly ongoing education.
600 elective knee and hip arthroplastic patients are collected. 200 patients before AG-
service will be compared to 400 patients after AGS. The latter group is divided to two 200
patients groups: 1) with AGS 2) with AGS extended to first control in 3 months (AG- nurse may
be contacted by phone). Patients are followed up up to 5 years. Controls will be held after 3
months, 1 year and 5 years after operation including B-Hba1c, 15 D Quality of life assessment
and patient interview.
There are several aims of the team and study: to detect, diagnose and optimize treatment
(including medication) of diabetic/ dysglycemic patients from preoperative assessment 1 week
before operation to postoperative care. With blood glucose target 42 - 86 mmol/mol results
better overall survival, lesser complications (i.e. infections, cardiovascular or renal
complications) and shorter length of hospital stay. Other aim is to find undiagnosed
diabetics or those at risk of developing diabetes. One aim is to find risk factors, which
lead to stress hyperglycemia during perioperative period or diabetes in 5 years.
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