Perioperative medicine & outcomes
Perioperative High‐Dose Steroid in Insulin‐Treated Patients With Diabetes Undergoing Fast‐Track Hip and Knee Arthroplasty: Impact on Length of Stay and Discharge Blood Glucose Levels
Authors' conclusion
Glucose levels at discharge were slightly, but significantly higher in insulin-treated patients with diabetes receiving high-dose steroids compared to those receiving no/antiemetic doses and to non-insulin treated diabetes patients receiving high-dose steroids. However, there was no increase in fraction with LOS > 2 days or 30-day readmissions in the patients having high-dose steroids.
Study context
- Population
- Patients with insulin-treated diabetes undergoing fast-track hip or knee arthroplasty64% high-dose steroids
- Participants
- 292 patients
- Exposure
- Perioperative high-dose steroid vs no/antiemetic steroid
- Outcome
- Discharge blood glucose concentration
- Follow-up
- Mean discharge
Methodological detailsmulticentre, eight Danish centres
- Multicentre
- Eight Danish centres
Main finding
As reported in the abstract
Discharge blood glucose
P = 0.011
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Mean difference (mmol/L) (95% CI) | P value | |
|---|---|---|---|
| Discharge blood glucose, insulin-treated vs propensity-matched non-insulin-treated diabetes, all high-dose steroid (sensitivity analysis) · mean dischargePropensity-score matched cohort | 2.1 (1.3–2.8) | P = < 0.001 | |
| −2024Difference, mmol/L (linear scale) |
| Outcome | High-dose steroid | No/antiemetic steroid | P value |
|---|---|---|---|
| LOS > 2 days | 10.1% (95% CI 6.6–15.3) | 15.2% (95% CI 9.6%–23.3%) | P = 0.200 |
| 30-day readmission | 8% (95% CI 4.8–13) | 8.3% (95% CI 4.3–15.6) | P = 0.923 |
Original publication
Perioperative High‐Dose Steroid in Insulin‐Treated Patients With Diabetes Undergoing Fast‐Track Hip and Knee Arthroplasty: Impact on Length of Stay and Discharge Blood Glucose Levels. Acta Anaesthesiol Scand. Published 22 July 2025. doi:10.
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