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Hyperglycemia in the Perioperative Period
Rebecca Shuford1, Jennifer L Miller-Ocuin2
1Department of Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina.
Clinics in Colon and Rectal Surgery
|April 28, 2023
Summary
Perioperative hyperglycemia, or high blood sugar during surgery, increases risks like infection and mortality. Insulin therapy and glycemic targets can help manage this risk in surgical patients.
Area of Science:
- Surgical patient care
- Endocrinology
- Metabolic disorders
Background:
- Perioperative hyperglycemia is a significant risk factor for surgical patients.
- Elevated blood glucose levels correlate with increased infection rates and mortality in both diabetic and non-diabetic individuals.
- Stress hyperglycemia induces insulin resistance, complicating glucose management.
Purpose of the Study:
- To highlight the risks associated with perioperative hyperglycemia.
- To emphasize the role of insulin administration in mitigating complications.
- To underscore the importance of glycemic targets in managing surgical patient blood glucose levels.
Main Methods:
- Review of existing literature on perioperative hyperglycemia.
- Analysis of the impact of stress hyperglycemia on insulin resistance.
- Examination of the efficacy of insulin therapy in reducing surgical complications.
- Discussion of individualized glycemic targets for perioperative glucose control.
Main Results:
- Perioperative hyperglycemia is linked to adverse outcomes, including infection and mortality.
- Stress-induced hyperglycemia leads to insulin resistance.
- Insulin administration effectively reduces complications associated with high blood sugar.
- Established glycemic targets offer a framework for personalized patient management.
Conclusions:
- Effective management of perioperative hyperglycemia is crucial for improving surgical patient outcomes.
- Individualized glycemic targets are essential for optimizing treatment throughout the preoperative, intraoperative, and postoperative phases.
- Insulin therapy is a key intervention for controlling hyperglycemia and its associated risks in surgical settings.
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