[Surgical operations in diabetics]

In view of the increasing incidence of diabetes, in particular in the second half of life, the number of patients in need of surgery will in the future grow disproportionately. In the pre-operative period, adequate metabolic control must have been achieved, and must be maintained intraoperatively and postoperatively. Peri-operative blood sugar levels of between 100 and 140 mg/dl improve outcome and reduce wound healing disorders. Only in the case of minor surgical procedures is it acceptable, depending on prior treatment, initially merely to keep the operative and postoperative course of the blood sugar level under observation, so as, in the event of an increase, to initiate controlled glucose-insulin-potassium (GIK) therapy, which must always be applied for major surgery and in type I diabetics. An increase in blood sugar concentrations above 140 mg/dl is undesirable, and a rise exceeding 180 mg/dl must be avoided at all costs.