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Perioperative Glycemic Management in the Adult Patient.

Elizabeth W Duggan1, C David Mazer2

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The Medical Clinics of North America
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PubMed
Summary

Effective perioperative management for diabetes mellitus involves preoperative evaluation, surgical day glucose control, and postoperative care. This includes assessing glycated hemoglobin, hypoglycemia risks, and carbohydrate intake for optimal patient outcomes.

Keywords:
Carbohydrate drinksDiabetes (type 1 and type 2)Hemoglobin A1CHyperglycemiaHypoglycemiaInsulinPerioperative diabetes care

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Area of Science:

  • Anesthesiology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Diabetes mellitus (DM) poses significant challenges in perioperative settings.
  • Effective management requires addressing preoperative risks, intraoperative glucose fluctuations, and postoperative transitions.

Purpose of the Study:

  • To review current best practices for perioperative diabetes mellitus management.
  • To provide guidance on preoperative evaluation, intraoperative glucose monitoring, and postoperative care.
  • To summarize consensus recommendations for blood glucose targets and present practical algorithms.

Main Methods:

  • Review of current literature and consensus recommendations.
  • Analysis of preoperative risk factors including glycated hemoglobin and hypoglycemia risk.
  • Development of practical algorithms for blood glucose testing and treatment.

Main Results:

  • Perioperative diabetes management necessitates thorough preoperative risk assessment.
  • Day-of-surgery glucose testing and treatment planning are critical.
  • Transitioning to a postoperative diabetes regimen requires careful consideration.

Conclusions:

  • Optimizing perioperative blood glucose control is essential for patient safety and outcomes in diabetes mellitus.
  • Consensus recommendations provide targets for both inpatient and ambulatory settings.
  • Practical algorithms aid clinicians in testing and treatment decisions.