Peri-operative management of diabetic patients. Any changes for the better since 1985?

Two hundred and seven anaesthetists in the Oxford region were sent a questionnaire asking about their peri-operative management of patients with diabetes mellitus. One hundred and seventy two valid returns were received. The results of this survey were compared with those of a similar survey conducted in 1985. A greater proportion of anaesthetists in 1993 would maintain their diabetic patients with a peri-operative blood glucose concentration of less than 10 mmol.l-1. Anaesthetists are more likely to be interventional in their management of diabetic patients than in 1985 and the methods used have changed in relative popularity. In 1993 diabetic patients undergoing major surgery were most commonly managed with separate infusions of insulin and glucose, while in 1985 the combined infusion of glucose, insulin and potassium was the most popular technique. The use of protocols in hospitals may increase the degree of uniformity of practice between anaesthetists.