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Validity of Glucose Measurement Methods During Surgery: A Systematic Review.

Lambert Heatlie1, Maede Ejaredar1, Kirstie C Lithgow1

  • 1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Canadian Journal of Diabetes
|April 16, 2026
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Summary

Accurate intraoperative glucose measurement remains a challenge for anesthesiologists. This review highlights the need for standardized methods to ensure patient safety during surgery.

Keywords:
diabetesdiabèteglycemic managementhyperglycémie peropératoireintraoperative glucose measurementintraoperative hyperglycemiamesure peropératoire de la glycémieprise en charge de la glycémie

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Area of Science:

  • Anesthesiology
  • Clinical Chemistry
  • Medical Device Technology

Background:

  • Intraoperative hyperglycemia is linked to poor patient outcomes.
  • Current glucose measurement and management during surgery have quality gaps.
  • Anesthesiologists face challenges in accurately measuring intraoperative glucose levels.

Purpose of the Study:

  • To systematically review literature on the precision and accuracy of intraoperative glucose measurement.
  • To inform clinical decision-making for anesthesiologists regarding glucose monitoring.
  • To identify gaps in current intraoperative glucose measurement practices.

Main Methods:

  • Systematic search of MEDLINE, PubMed, EMBASE, and CINAHL (inception–2024).
  • Included English-language studies comparing glucose measurement methods in adult, non-pregnant surgical patients.
  • Data extraction and screening performed in duplicate.

Main Results:

  • 23 studies involving 1,258 patients and 4,071 glucose measurements were analyzed.
  • Significant heterogeneity existed in study designs, blood sources, and measurement methods, precluding meta-analysis.
  • Most studies did not adhere to international accuracy standards for glucose measurement.

Conclusions:

  • The optimal method for intraoperative glucose measurement is currently unknown.
  • Anesthesiologists should carefully consider method characteristics for their specific clinical setting.
  • Further research is needed to establish standardized and accurate intraoperative glucose monitoring techniques.