Continuing Home Oral Hypoglycemic Medications Was Associated With Superior Postoperative Glycemic Control Versus Initiating Sliding Scale Insulin After Total Hip Arthroplasty.

This retrospective study examined the effects of continuing versus discontinuing home oral hypoglycemic regimens in patients with diabetes undergoing primary total hip arthroplasty (THA). Among 532 patients managed exclusively with oral hypoglycemic agents preoperatively, those who continued their home regimen postoperatively demonstrated significantly better inpatient glycemic control, lower rates of acute kidney injury (AKI) and metabolic acidosis, and shorter hospital length of stay compared to those who discontinued oral agents in favor of basal insulin with or without sliding scale insulin (SSI). The study found no increase in renal or metabolic complications associated with continuing oral hypoglycemic medications, challenging traditional concerns about their inpatient use. These findings suggest that, for select patients, maintaining home oral hypoglycemic therapy after THA may improve postoperative outcomes, though further prospective research is needed to confirm safety and efficacy across broader populations.