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Surgery in the diabetic patient

C R Shuman

    Comprehensive Therapy
    |January 1, 1982
    PubMed
    Summary

    Managing diabetes during surgery requires insulin to prevent hyperglycemia and protein breakdown. Intravenous glucose-insulin infusion offers a safe and effective method for blood sugar control in diabetic patients undergoing surgery.

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    Area of Science:

    • Endocrinology
    • Surgical Management
    • Metabolic Disorders

    Background:

    • Diabetic patients face unique challenges during surgery due to insulin deficiency and counter-regulatory hormone response.
    • Perioperative hyperglycemia, ketosis, and protein catabolism are significant risks in diabetic surgical patients.
    • Pre-existing diabetes complications, especially cardiovascular issues, can complicate surgical outcomes.

    Purpose of the Study:

    • To outline an effective perioperative management strategy for diabetic patients.
    • To highlight the benefits of intravenous glucose-insulin infusion for surgical glycemic control.
    • To emphasize the importance of managing fluid balance, electrolytes, and infection.

    Main Methods:

    • Utilizing intravenous glucose-insulin infusion for both Type I and Type II diabetes during surgical procedures.
    • Continuous monitoring of blood glucose concentrations to guide insulin dosage adjustments.
    • Maintaining optimal fluid and electrolyte balance and implementing infection prevention protocols.

    Main Results:

    • Intravenous glucose-insulin infusion effectively prevents hyperglycemia and its associated metabolic derangements.
    • This method allows for precise blood glucose control, minimizing risks of both hyperglycemia and hypoglycemia.
    • The regimen is adaptable for both elective and emergency surgical interventions.

    Conclusions:

    • Intravenous glucose-insulin infusion is a safe, effective, and simple perioperative management strategy for diabetic patients.
    • This approach helps mitigate surgical stress-induced metabolic complications in diabetes.
    • Careful monitoring and management are crucial for successful surgical outcomes in diabetic individuals.

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