Doctors trial new support programme to make surgery safer for people with diabetes


Doctors in Southampton are trialling an innovative eight to 12 week support programme for people with diabetes to help improve patient outcomes post-surgery.

Professor Richard Holt, a diabetes consultant based at University Hospital Southampton NHS Foundation Trust, is leading the OCTOPuS study to see if specialist support in the weeks before surgery can reduce recovery times and improve survival rates of people with type 2 diabetes who undergo heart surgery.

An increased risk of complications

In the UK, around one in five people who undergo heart surgery have diabetes, and those whose diabetes is not well controlled usually recover more slowly and have a higher risk of developing post-surgery infections. After surgery it is estimated that people with diabetes need to stay in hospital for nearly 50% longer than those without.

Based on previous research, which has shown that improving diabetes-management in the weeks before surgery can reduce the length of stay for people receiving joint replacements, Professor Holt’s team is now looking to adapt this approach for patients undergoing heart operations.

The study team hope the extra support will help people manage their diabetes better, leading to better outcomes from surgery and shorter recovery times.

Specialist support

At first, around 20-30 patients will take part in a ‘feasibility’ study to test the practicality of this approach, which involves a diabetes specialist (either a doctor, nurse, pharmacist or other trained professional) meeting with each patient around eight to 12 weeks before their planned surgery to develop a personalised plan and improve how they manage their condition.

Participants will then follow the plan at home, which could include making healthy changes to their diet, losing weight or changing their medication. This will be followed up with weekly telephone calls from the specialist to check on their progress and address any concerns.

If successful, all people with type 2 diabetes who are due to have heart surgery at Southampton General Hospital will then be offered the opportunity to take part.  

“Diabetes is becoming increasingly common and there are a number of reasons why this patient group are at greater risk of complications post-surgery, including obesity, high blood pressure and lower physical fitness,” explained Prof Holt.

“The aim of our study and intervention is to try and improve the risk factors that can be changed, such as glucose levels, weight, diet and exercise and activity levels.”

Next steps

The trial is a collaboration between University Hospital Southampton NHS Foundation Trust and the University of Southampton, funded by the National Institute for Health Research (NIHR) and coordinated by the Southampton Clinical Trials Unit. 

Prof Holt said: “Ultimately, our goal would be to trial this support service in clinics across the UK, to help reduce complications and improve outcomes from heart surgery in people with type 2 diabetes.”

“Not only does this have the potential to benefit a large number of patients, but reducing the time it takes for them to recover after surgery could also reduce the costs associated with treatments and save NHS money."

Posted on Monday 8 July 2019