Stress hyperglycaemia or diabetes mellitus in cervicofacial infections? A Maxillofacial Surgery Trainees Research Collaborative (MTReC) Study

Abstract Introduction Diabetes mellitus (DM) is thought to be associated with poor outcomes in cervicofacial infections (CFI), yet little is known about the prevalence of DM in CFI. Stress hyperglycaemia (SHG), a normal physiological response to inflammation, is distinct from DM, though they overlap and may be conflated. We aimed to establish the prevalence of DM and SHG in CFI and determine the effect of each on severity of disease and outcome measures. Methods The Maxillofacial surgery trainees research collaborative carried out an audit of all CFI admitted to 25 hospitals between May and October 2017. This created the largest prospective database of CFI, with information collected on presentation, source of infection, biological data, and outcomes. Results We recorded 1002 admissions, of which 78 (7.8%) had DM. Random blood glucose was measured on admission in 401 patients (40%), of which 45 (11%) displayed SHG. Patients diagnosed with DM were more likely to have infections arising from a salivary source (13% vs 4%, p  Discussion The prevalence of DM in our cohort is only marginally higher than the general population, despite previous retrospective case reviews suggesting a significantly higher prevalence. SHG is not associated with poor outcomes in our cohort, but is likely to be associated with a small increase in risk of subsequent diagnosis of DM, which can be quantified using a calculator tool. It is important to give appropriate diet, lifestyle, exercise and weight loss advice to all patients with CFI on discharge.