{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:25:36Z","timestamp":1790727936175,"version":"4.1.0"},"reference-count":37,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korea University Ansan Hospital","award":["K2409171"],"award-info":[{"award-number":["K2409171"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Perioperative hyperglycemia is associated with increased risks of infection and mortality. Patients with type 2 diabetes mellitus (T2DM) exhibit variable glycemic responses to surgical stress, highlighting the importance of optimal perioperative glucose control. The aim of this study is to conduct a systematic review and meta-analysis comparing the effects of intravenous versus inhalation anesthesia on perioperative blood glucose levels in patients with T2DM undergoing surgery. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized studies identified from Medline, EMBASE, CENTRAL, and Google databases up to 24 October 2024. Eligible studies included adult surgical patients with type 2 diabetes mellitus. Two investigators independently screened studies, extracted data, and assessed methodological quality using the GRADE approach. Results: Five studies (3 RCTs and 2 non-RCTs) involving a total of 512 participants were included. Intraoperatively, inhalation anesthesia was associated with significantly higher blood glucose levels compared to intravenous anesthesia (mean difference [MD]: 12.52 mg\/dL; 95% confidence interval [CI]: 0.70\u201324.35) in the overall analysis. However, subgroup analysis by study design showed no significant differences. Postoperatively, inhalation anesthesia resulted in significantly higher glucose levels than intravenous anesthesia, both in the overall analysis (MD: 23.56 mg\/dL; 95% CI: 3.65\u201343.48) and in RCTs alone (MD: 28.20 mg\/dL; 95% CI: 3.67\u201352.73). Conclusions: Intravenous anesthesia is associated with lower perioperative blood glucose levels compared to inhalation anesthesia, both during and after surgery. Although the effect was not consistently significant across all subgroups, these findings suggest a potential advantage of intravenous anesthesia in patients with T2DM and warrant validation in larger randomized trials.<\/jats:p>","DOI":"10.3390\/medicina62010128","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T14:32:38Z","timestamp":1767882758000},"page":"128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Intravenous or Inhalation Anesthesia on Blood Glucose in Patients with Type 2 Diabetes Mellitus: A PRISMA-Compliant Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"62","author":[{"given":"Sang Min","family":"Yoon","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Ansan 15355, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2844-5880","authenticated-orcid":false,"given":"Hyun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3031-357X","authenticated-orcid":false,"given":"Yoon Ji","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Ansan 15355, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3869-9470","authenticated-orcid":false,"given":"Sang Hun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju 61453, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6245-9779","authenticated-orcid":false,"given":"Seongtae","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4002-5520","authenticated-orcid":false,"given":"Sejong","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Korea University College of Medicine, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1001\/jama.2017.7596","article-title":"Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013","volume":"317","author":"Wang","year":"2017","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"611","DOI":"10.2337\/dc13-1929","article-title":"Preoperative A1C and clinical outcomes in patients with diabetes undergoing major noncardiac surgical procedures","volume":"37","author":"Underwood","year":"2014","journal-title":"Diabetes Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1213\/ANE.0000000000000100","article-title":"Increased glycemic variability in patients with elevated preoperative HbA1C predicts adverse outcomes following coronary artery bypass grafting surgery","volume":"118","author":"Subramaniam","year":"2014","journal-title":"Anesth. 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