Management of Diabetes Mellitus and Hypertension During Hospitalization in Maxillofacial Departments

TL;DR

This study examines how diabetes and hypertension are managed in hospitalized oral and maxillofacial surgery patients and finds that blood pressure and glucose levels can significantly decrease with proper care.

Contribution

The study provides insights into managing diabetes and hypertension in a specific surgical setting and highlights the value of specialist consultations.

Findings

Systolic blood pressure significantly decreased in stages 1 and 2 hypertension patients during hospitalization.

Blood glucose levels significantly dropped in diabetic patients with initial values above 250 mg/dL.

Endocrinologist consultations led to a significant reduction in blood glucose levels among diabetic patients.

Abstract

Background and Objectives: Diabetes mellitus (DM) and hypertension (HTN) continue to increase and pose a significant burden on the health system worldwide. These patients comprise a significant portion of the hospitalized Oral and Maxillofacial Surgery (OMFS) department. Addressing and controlling DM and HTN during hospitalization should thus be one of the treatment goals. This study aims to investigate the management and outcomes of DM and HTN during the hospitalization period in the OMFS department. Materials and Methods: A retrospective analysis of patients with community-diagnosed DM and/or HTN admitted to the OMFS department between 2017 and 2019 was conducted at Rambam Healthcare Campus, Haifa, Israel. Linear regression analysis was used to determine trends in changes in blood pressure and blood glucose levels during hospitalization. The impact of consults from internal medicine experts and endocrinologists was tested using a paired-samples t-test. Results: A statistically significant reduction was observed in all systolic HTN patients categorized as stages 1 and 2, p = 0.012 and p = 0.001, respectively. A statistically significant (p = 0.012) reduction in blood glucose levels in all DM patients with initial values higher than 250 mg/dL was observed. A statistically significant reduction in blood glucose levels was observed in the DM group of patients who received endocrinologist consultations (p = 0.012). Conclusions: Addressing patients with systemic conditions during hospitalization in the OMFS department is mandatory. External medical consulting can be of great value for short-term treatment during hospitalization and may also have long-term benefits after discharge to the community. The main limitations of this study include retrospective data acquisition, a small sample size, and a lack of data regarding the impact of pain management on blood pressure and glucose levels.

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