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Related Concept Videos

Hyperglycemia01:29

Hyperglycemia

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Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose...
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Hypoglycemia and Glucagon01:15

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Hypoglycemia01:26

Hypoglycemia

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Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
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Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Complications of Diabetes Mellitus01:22

Complications of Diabetes Mellitus

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Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
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Improving IV Insulin Administration in a Community Hospital
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Hyperglycemia and ambulatory surgery.

J A Polderman1, L Van Velzen, L G Wasmoeth

  • 1Department of Anesthesiology, Academic Medical Centre, Amsterdam, The Netherlands - b.preckel@amc.uva.nl.

Minerva Anestesiologica
|January 17, 2015
PubMed
Summary
This summary is machine-generated.

Ambulatory surgery patients experienced a minor glucose increase, not linked to complications. Dexamethasone use, not hyperglycemia, predicted glucose rise. Pre-existing diabetes, however, increased complication risk.

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Area of Science:

  • Anesthesiology
  • Endocrinology
  • Surgical Outcomes

Background:

  • Perioperative hyperglycemia correlates with increased complications in major surgery.
  • Ambulatory surgery, comprising over 50% of procedures, often lacks routine glucose monitoring.
  • Understanding glucose dynamics in ambulatory settings is crucial for patient safety.

Purpose of the Study:

  • To assess capillary glucose changes during ambulatory surgery.
  • To identify risk factors for perioperative glucose elevation.
  • To determine if perioperative hyperglycemia predicts postoperative complications in ambulatory surgery.

Main Methods:

  • A prospective, multicenter cohort study included adult patients undergoing ambulatory surgery.
  • Capillary glucose was measured 1 hour preoperatively and 1 hour postoperatively.
  • Postoperative complications were assessed via patient contact at 90 days.

Main Results:

  • Median glucose increased slightly from 5.4 to 5.6 mmol/L (P<0.001).
  • Hyperglycemia (≥7.8 mmol/L) occurred in 8.8% of patients; dexamethasone use was a risk factor for glucose increase (P<0.001).
  • Hyperglycemia did not predict complications (OR 1.19), but prediagnosed diabetes mellitus did (OR 2.56, P=0.030).

Conclusions:

  • Minor ambulatory surgery is not associated with clinically significant glucose increases.
  • Observed glucose elevation may be linked to dexamethasone for postoperative nausea and vomiting prophylaxis.
  • Hyperglycemia during ambulatory surgery does not appear to predispose patients to complications post-discharge.