[Diabetes mellitus in Anaesthesia - Optimal Blood Sugar Control in the Perioperative Phase]

Uncontrolled high blood sugar can be dangerous for diabetics throughout the perioperative period - in particular, when blood glucose levels exceed a threshold of 250 mg/dl or HbA_1c levels are higher than 8.5 - 9%. In such cases, all elective surgery should be withheld to minimize the risk of severe complications. Due to their cardiovascular comorbidities, diabetics are commonly overrepresented in hospitals, tend to require inpatient care for an extended period of time, and suffer from higher mortality rates. In order to reduce negative outcomes, blood glucose levels should be targeted to 140 - 180 mg/dl on intensive care units or during surgery. Current literature suggests that non-critically ill diabetics should be treated with rapid-acting insulin analogues subcutaneously in operating theatres, whereas critically ill patients should receive continuous intravenous insulin infusions using a standardized protocol. In summary, this review can give a hand in dealing with diabetics during the perioperative period and offers guidance in controlling blood sugar levels with the help of oral antidiabetic drugs and insulin.