As actor and comedian Tracy Morgan recovers from the traumatic injuries he suffered during a car accident on Saturday, his prognosis may be complicated by the fact that he suffers from diabetes, according to one expert.
The “30 Rock” star underwent surgery Sunday to treat a broken leg, and also sustained a broken femur, broken nose, and several broken ribs during the accident. While it had been rumored that Morgan may lose his leg, his representative said the claims were false.
For a patient like Morgan, who suffers from diabetes, medical personnel must pay special attention to monitoring blood sugar levels and mitigating the risk of infection while treating traumatic injuries, Dr. Laurence Kennedy, an endocrinologist and chairman of the department of endocrinology, diabetes and metabolism at Cleveland Clinic in Ohio, told FoxNews.com. Kennedy is not involved with Morgan’s recovery.
“Getting broken bones is very stressful in that it leads to an outpouring of counterregulatory hormones, like adrenaline [and] cortisol, that push up the blood sugar level,” Kennedy said. “In someone with diabetes, one might expect that serious injuries would result in higher blood sugars than they have been experiencing recently.”
Patients in emergency surgery situations are typically treated with insulin to regulate blood sugar. If a patient has Type 1 diabetes, they will already be on treatment with insulin. Patients with Type 2 diabetes may not be on insulin at the time of hospital admission, but will almost certainly need to be treated with insulin during the admission, Kennedy said. Good control of blood sugar levels around the time of surgery helps reduce the likelihood of infection, he noted. Other short-term complications could include dehydration and decreased kidney function.
Type 2 diabetes is often accompanied by high blood pressure, cholesterol and triglyceride levels, all risk factors for generalized vascular disease.
“[The hospital] would need to look very carefully to make absolutely sure that someone has adequate heart function, doesn’t have undiagnosed coronary heart disease, and make sure the heart is pumping satisfactorily,” Kennedy said. “That would be a major issue as far as that’s concerned.”
Morgan also underwent a kidney transplant in December 2010 – which may further complicate some of his treatments. According to Kennedy, most patients who have undergone a kidney transplant take long term, low dose steroids, which may complicate any future surgeries.
“In a normal situation, when someone perfectly healthy has a fracture or accident and requires treatment or surgery, their body’s adrenal glands automatically produce higher levels of cortisol to help the body respond to the stress of the situation,” Kennedy said. “If you’re being treated long term with steroids, your body is unable to respond this way. Therefore doctors have to respond on your behalf by increasing the amount of steroids a patient is given,”
Administering increased levels of steroids slightly complicates the body’s ability to regulate blood sugar, because high levels of steroids can increase blood sugar levels. However, this type of complication is relatively easy to manage, Kennedy said.
Fortunately, modern medical care and treatments offer an an optimistic outlook for diabetes patients after injury and surgery, Kennedy said.
“As a general rule, it’s probably fair to say that a history of diabetes would put you at greater risk of a not-so-good an outcome than if you don’t have a history of diabetes, but yet the majority with a history of diabetes, even complicated, will come through situation like this well with appropriate management,” he said.