Karmakar R, Kaushik A, Gade P, Gawali M, Mukundan A. Diabetes as a determinant of neurosurgical vulnerability: Rethinking perioperative risk in meningioma resection. World J Diabetes 2026; 17(7): 119009 [DOI: 10.4239/wjd.119009]
Corresponding Author of This Article
Arvind Mukundan, Associate Professor, Senior Postdoctoral Fellow, Senior Researcher, Department of Computer Science, School of Engineering and Technology, Sanjivani University, Singnapur, Kopargaon, Kopargaon 423603, Mahārāshtra, India. arvindmukund96@gmail.com
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Karmakar R, Kaushik A, Gade P, Gawali M, Mukundan A. Diabetes as a determinant of neurosurgical vulnerability: Rethinking perioperative risk in meningioma resection. World J Diabetes 2026; 17(7): 119009 [DOI: 10.4239/wjd.119009]
World J Diabetes. Jul 15, 2026; 17(7): 119009 Published online Jul 15, 2026. doi: 10.4239/wjd.119009
Diabetes as a determinant of neurosurgical vulnerability: Rethinking perioperative risk in meningioma resection
Riya Karmakar, Ananya Kaushik, Pratham Gade, Mahendra Gawali, Arvind Mukundan
Riya Karmakar, Department of Integrated Bachelor of Technology, School of Engineering and Technology, Sanjivani University, Kopargaon 423603, Mahārāshtra, India
Ananya Kaushik, Department of Artificial Intelligence and Machine Learning, School of Engineering and Technology, Sanjivani University, Kopargaon 423603, Mahārāshtra, India
Pratham Gade, Department of Information Technology, Sanjivani College of Engineering, Kopargaon 423603, Mahārāshtra, India
Mahendra Gawali, Arvind Mukundan, Department of Computer Science Engineering, School of Engineering and Technology, Sanjivani University, Kopargaon 423603, Mahārāshtra, India
Arvind Mukundan, Department of Biomedical Imaging, Chennai Institute of Technology, Chennai 600069, India
Co-first authors: Riya Karmakar and Ananya Kaushik.
Author contributions: Karmakar R and Kaushik A designed the research study, contributed equally to this article and are the co-first authors of this manuscript; Karmakar R, Kaushik A, Gade P, Gawali M, and Mukundan A performed the research; Karmakar R and Mukundan A wrote the manuscript; and all authors contributed to revisions.
AI contribution statement: We would like to clarify that no AI tool was used to generate the scientific content, study design, data, analysis, results, interpretation, conclusions, or images in the manuscript. The only AI-assisted tool used was QuillBot, and its use was limited to paraphrasing and language refinement to improve readability and reduce grammatical or stylistic issues. The manuscript was not written or generated by ChatGPT, DeepL, or any other generative AI tool.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Arvind Mukundan, Associate Professor, Senior Postdoctoral Fellow, Senior Researcher, Department of Computer Science, School of Engineering and Technology, Sanjivani University, Singnapur, Kopargaon, Kopargaon 423603, Mahārāshtra, India. arvindmukund96@gmail.com
Received: January 19, 2026 Revised: February 20, 2026 Accepted: May 13, 2026 Published online: July 15, 2026 Processing time: 173 Days and 13 Hours
Abstract
Diabetes mellitus is a comprehensive disorder that affects functions beyond immune response glucose regulation, vascular integrity and regenerative capacity. Recent studies on retrospective cohort highlights that diabetes is closely associated with adverse short- and long-term outcomes in meningioma patients following surgery. Studies revealed that patients with diabetes generally experience extended hospitalizations, high risk of surgical site infections, elevated postoperative cerebral edema, more severe neurological sequelae, and diminished functional recovery. Diabetes is also an important predictor of tumor recurrence and mortality, irrespective of time and event analysis. The literature study highlights diabetes as a relevant comorbidity in neurosurgical oncology rather than a passive background disease, since it can dynamically control postoperative inflammations, wound healing and brain function integrity, which are essentials for recovery after intracranial surgery. The established associations between diabetes, increased inflammatory markers, and clinically significant cerebral edema further support the role of metabolic dysregulation in raising neurosurgical risk. These findings have actual implications for preoperative care, as standard neurosurgical approaches can be insufficient for diabetic patients and may require improved glucose regulation, intense infection surveillance, aggressive edema management, and prolonged follow-up. The association of diabetes with long-term recurrence also raises questions about tumor biology, metabolic signaling and the effects of glycemic control on cancer prognosis. This review acknowledges that diabetes should be considered a significant predicator for neurosurgical risk in meningioma patients and not a comorbidity, and therefore, risk classification and treatment strategies are warranted. Future studies are needed to determine optimal glucose targets, to evaluate glycemic variation in the perioperative period and to ascertain whether tailored metabolic therapies can improve surgical outcome and prognosis.
Core Tip: Type 2 diabetes has a major effect on patients having tumor excision during and after the surgery. Higher chances of surgical site infection, cerebral edema, neurological issues, prolonged hospital stays, and risk of tumor recurrence can result in high blood sugar, long-term inflammatory phase, slower wound healing, and disturbance of the blood brain barrier. This review highlights the need for customized preoperative glucose control, thorough postoperative monitoring, and prolonged metabolic improvement in diabetic patients. Diabetes should be viewed as an active biological disorder with neurosurgical risk factors rather than a passive disorder.
