New guidance on the perioperative management of diabetes

People with diabetes are more likely to require surgical intervention than those without and have an increased risk of developing postoperative complications. The Highs and lows review from the National Confidential Enquiry into Patient Outcome and Death reported on inadequate diabetes care in the perioperative period. As a result, the Centre for Perioperative Care has published guidance on perioperative management of diabetes recently.Early identification and glucose optimisation pre-operatively is key, and assists in formulating an individualised plan for diabetes care during admission, surgery and postoperatively. The plan will include dose adjustments of diabetes medication, and use of variable rate insulin infusion or continuous subcutaneous insulin infusion where applicable. The guideline also highlights the importance of improved communication between healthcare teams involved in the perioperative pathway in order to improve outcomes and care.