[Management of diabetes during operative procedures]

The described basic scheme for the peroperative care of patients with diabetes mellitus which was for many years successfully used proved to be very efficient and improves the interdisciplinary care. On the basis of a standardized infusion programme in which the carbohydrates are given in combination as glucose and sorbite in many type II diabetics administrations of insulin and tolbutmide may be avoided. Modern anaesthesia techniques have a sedative effect on the postaggression syndrome. The change to oral fluid and food supply takes place as early as possible with adequate good results and advantages also after abdominal interventions. The diabetic and postoperative metabolism have both a common disturbed utilization of glucose which lead to catabolism with increased gluconeogenesis and lipolysis and additionally evoke complications. The necessary therapeutic measures may also be used in other non-postoperative postaggression syndromes without presence of diabetes mellitus. It is particularly referred to the dangers of a too schematic approach.