OBJECTIVE: To determine whether a prior diagnosis of diabetes mellitus (DM) is associated with longer postoperative length of stay (LOS) and higher complication rates among patients who underwent colorectal surgery under an Enhanced Recovery After Surgery (ERAS) protocol in a single hospital setting.

METHODOLOGY: In a cross-sectional study, we grouped 157 consecutive patients who underwent elective colorectal surgery under ERAS protocol according to preoperative DM status. Patient data was abstracted from the ERAS Interactive Audit Database from January 2016 to December 2017. We compared LOS between groups. Secondary outcomes were postoperative complications, reoperations, pneumonia and wound infection. Categorical and continuous variables were analyzed with Fisher's exact test and student's t-test, respectively, using Stata/SE version 13 with a significance level of p=0.05.

RESULTS: One hundred thirteen subjects did not have diabetes (no T2DM) while 44 patients had type 2 diabetes mellitus (T2DM). Mean postoperative length of hospital stay was 6.4±5.1 days for the no T2DM group versus 5.8±3.8 in the T2DM group (p=0.476). Complications, reoperation rate, pneumonia and wound infection did not differ between groups. Among subjects in the T2DM group, LOS did not differ between patients with preoperative HbA1c ?7.0% and those with HbA1c >7.0% (5.7±3.7 versus 6.1±4.2 days, p=0.748).

CONCLUSION: Among patients who underwent colorectal surgery under ERAS protocol, a prior diagnosis of diabetes was not associated with longer LOS or more complications. A preoperative HbA1c of <7% did not affect length of stay in ERAS among patients with T2DM.

Human ; Colorectal Surgery ; Diabetes Mellitus ; Length Of Stay

A Technical Working Group composed of health professionals and multispecialty healthcare experts, have come together to emphasize the crucial role of nutrition in promoting overall health and wellbeing. Nutrition serves as the cornerstone of optimal physical and mental functioning, and they firmly believe that a well-balanced diet should be the primary source of essential nutrients for individuals of all ages. However, they acknowledge the existence of prevalent gaps in nutrition and the potential benefits of oral micronutrient supplementation particularly those that contain iron and appetite stimulants in addressing these gaps across the entire disease spectrum. Despite the importance of nutrition, various factors like appetite loss due to medications and illnesses contribute to gaps in dietary intake. Modern dietary patterns, often characterized by highly processed foods, excessive added sugars, unhealthy fats, and insufficient intake of fruits, vegetables, whole grains, and lean proteins, can result in nutrient deficiencies. Additionally, socio-economic factors, cultural practices, limited access to nutritious food options, and individual dietary restrictions may further contribute to these gaps. Moreover, individuals who have poor appetite and nutrient intakes with certain conditions, or those who avoid certain foods (such as strict vegetarians and vegans) might benefit from taking supplementation. Multivitamin supplementation can play a supportive role in addressing nutritional gaps. These supplements, when used appropriately and as part of a balanced diet, can provide a convenient and reliable source of essential vitamins and minerals. Multivitamins are particularly useful in situations where dietary intake alone may not meet individual nutrient requirements due to limitations or specific health conditions. They offer an accessible option to help bridge the nutritional gaps and ensure adequate nutrient intake.

Background: Malnutrition is a condition of imbalances in the intake of nutrients and fluids which may translate to poor health outcomes. Based on the Expanded National Nutrition Survey in 2018, eight percent of Filipino adults were found to have chronic energy deficiency (undernutrition), and is most prevalent among the elderly population, residents of the rural area and poorest quintile. Currently, there are no available local guidelines for malnutrition in Filipino adults. Objective: The general objective of this pathway is to improve the quality of health care of the Filipino family through proper recognition and management of malnutrition. Method The PAFP Nutrition Pathway Working Group reviewed published medical literature to identify, and summarize, the clinical content of clinical indicators, diagnostics, interventions, and outcomes to develop an evidence-based clinical pathway in family practice. The group developed a time-related representation of recommendations on patient-centered processes in terms of history and physical examination, laboratory tests, pharmacologic and non-pharmacologic interventions, as well as family-focused interventions and community strategies to properly recognize and treat adults with malnutrition.