Impact of diabetes mellitus history on postoperative infectious complications in gastric or colorectal cancer patients

doi:10.4240/wjgs.117631

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jun 27, 2026; 18(6): 117631
Published online Jun 27, 2026. doi: 10.4240/wjgs.117631

Impact of diabetes mellitus history on postoperative infectious complications in gastric or colorectal cancer patients

Ying-Ying Peng, Maimaiti Amannisha, Li-Dan Chen

Ying-Ying Peng, Department of Oncology, Zhebei Mingzhou Hospital, Huzhou 313000, Zhejiang Province, China

Maimaiti Amannisha, Department of Medical Oncology, Shache County People’s Hospital, Shache 844700, Xinjiang Uygur Autonomous Region, China

Li-Dan Chen, Department of Emergency, Xuchang Central Hospital, Xuchang 461000, Henan Province, China

Author contributions: Peng YY was responsible for the study design, data acquisition, and drafting of the manuscript; Amannisha M contributed to data analysis, interpretation, and manuscript preparation; Chen LD supervised the entire research process, provided critical revisions for intellectual content, and approved the final version for submission; and all authors thoroughly reviewed and endorsed the final manuscript.

AI contribution statement: No AI tools were utilized for language polishing, translation, data analysis or any form of writing assistance during the manuscript preparation. AI tools did not participate in the design of the study or the interpretation of the research results in any way. All images included in the manuscript are original and were not generated by any AI tools.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Zhebei Mingzhou Hospital, Huzhou, approval No. 2025050.

Informed consent statement: All study participants and their legal guardians provided written informed consent before recruitment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

Corresponding author: Li-Dan Chen, Research Fellow, Department of Emergency, Xuchang Central Hospital, No. 30 Huatuo Road, Weidu District, Xuchang 461000, Henan Province, China. chendanxcszxyy@sina.com

Received: January 27, 2026
Revised: February 10, 2026
Accepted: March 5, 2026
Published online: June 27, 2026
Processing time: 143 Days and 12.2 Hours

Abstract

BACKGROUND

Postoperative infectious complications remain one of the major causes of morbidity in gastric or colorectal cancer patients who opt for surgical intervention. Diabetes mellitus has been previously shown to impair immune and metabolic functions, thereby increasing the potential risk of postoperative infections. However, very limited evidence is available to establish the same in gastrointestinal cancer patients.

AIM

To assess the effect of diabetes mellitus history on postoperative infectious complications observed in gastric or colorectal cancer patients.

METHODS

The study included 200 gastric or colorectal cancer patients (admitted from January, 2022 to January, 2025). The occurrence of infectious complications within 30 days of surgery was recorded, following which the patients were divided into two groups: (1) The postoperative infection group (n = 48); and (2) The non-infection group (n = 152). On the basis of diabetes history, the participants were further divided into the diabetes group (n = 62) and the non-diabetes group (n = 138). Risk factors for postoperative infectious complications were assessed, with odds ratios and 95% confidence intervals specifically calculated concerning diabetes history.

RESULTS

Among 200 subjects included in the study, 48 patients showed postoperative infectious complications. Out of these, only 25 (52.08%) patients had a previous history of diabetes. Interestingly, surgical site infection was found to be the most common complication [27 (56.3%) cases], followed by pulmonary infection [11 (22.9%) cases]. The univariate and multivariate logistic regression analyses further revealed that diabetes history with preoperative glycated hemoglobin A1c ≥ 7.0% and preoperative hypoalbuminemia (albumin < 35 g/L) acted as independent risk factors for postoperative infectious complications in gastric or colorectal cancer patients (P < 0.05).

CONCLUSION

Altogether, diabetes mellitus acted as a significant independent risk factor that increased the overall incidence of postoperative infectious complications in gastric/colorectal cancer patients. The observed risk might be attributed to certain mechanisms that affect different metabolic and immune functions. Strategies focusing on comprehensive assessment, intervention, and better management strategies might aid in reducing the incidence of postoperative infectious complications in gastric or colorectal cancer patients, thereby improving overall patient prognosis and quality of life.

Keywords: Diabetes mellitus; Gastric cancer; Colorectal cancer; Postoperative infections; Complications

Core Tip: Diabetes mellitus acted as a significant independent risk factor in postoperative infectious complications reported in patients with gastric or colorectal cancer. Importantly, the patients with a known history of diabetes, characterized by elevated preoperative glycated hemoglobin A1c ≥ 7.0%, and hypoalbuminaemia (albumin < 35 g/L) displayed a higher risk of postoperative infectious complications. Surgical site infection was the most common postoperative infection, followed by pulmonary infection. Early identification, preoperative optimization of blood glucose and nutritional status, and targeted perioperative management might help to reduce the incidence of postoperative infections and improve overall patient outcomes.