Evaluation of difficult airway and difficult intubation in patients with and without diagnosis of diabetes

Introduction: Difficult airway management in diabetic patients is an important challenge that can lead to serious complications in anesthesia practices. While changes in connective tissues due to chronic hyperglycemia make airway control difficult, the high incidence of difficult intubation necessitates a comprehensive evaluation and appropriate equipment preparation. This study aimed to prospectively examine the risks of difficult laryngoscopy and intubation with various clinical parameters in patients with and without diabetes. Material Method: This study is a prospective observational study conducted between August and December 2024, with the approval of the local Ethics Committee (2024/169) and informed patient consent. 120 patients in ASA I-III group, aged 18-70 years, with (Group D) or without (Group N) DM for more than 5 years were evaluated in two groups. In preoperative and intraoperative evaluations, parameters such as age, gender, ASA classification, mallampati score and Wilson score were examined, and VIDIAC score, duration, number of attempts, SpO2 and other measurements were recorded during intubation. Results: When parameters related to difficult airway were evaluated in the study, no significant difference was found between the diabetic and non-diabetic groups in terms of Mallampati score, TMD distribution, Wilson score, VIDIAC score and upper lip bite test results (p>0.05). Conclusion: In our study, we observed that the incidence of difficult airway was higher in diabetic patients and recorded the difficult airway scores compared to the non-diabetic group. In conclusion, difficult airway management in diabetic patients is a complex condition that requires careful preoperative evaluation and a multidisciplinary approach. Although our study supports the existing literature, it emphasizes the need for more comprehensive and multicenter studies. In the future, studies evaluating different clinical parameters together may make significant contributions to the development of safe and effective airway management strategies in this patient group.