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Diabetes management in special situations

I B Hirsch1, D S Paauw

  • 1Division of Metabolism, University of Washington School of Medicine, Seattle, USA.

Endocrinology and Metabolism Clinics of North America
|October 6, 1997
PubMed
Summary

Managing diabetes in special situations like surgery or during glucocorticoid therapy can be challenging due to limited data. This review offers evidence-based strategies for perioperative diabetes management and other critical scenarios.

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Limited literature exists for managing diabetes in specific clinical scenarios.
  • Current practices often rely on training, community standards, and personal experience.
  • Effective diabetes management is crucial during critical illness and treatment.

Purpose of the Study:

  • To provide evidence-based recommendations for managing diabetes in challenging situations.
  • To address perioperative diabetes management.
  • To guide clinicians on managing diabetes during insulin infusion withdrawal, glucocorticoid treatment, and total parenteral nutrition (TPN).

Main Methods:

  • Review of pathophysiology of diabetes in special situations.
  • Analysis of pharmacokinetic and pharmacodynamic properties of available medications, especially insulin.
  • Integration of current clinical guidelines and expert opinion.

Main Results:

  • Detailed strategies for perioperative glucose control.
  • Guidance on managing hyperglycemia during glucocorticoid and TPN therapy.
  • Recommendations for safe discontinuation of insulin infusions.

Conclusions:

  • Clinicians can utilize evidence-based approaches for complex diabetes management.
  • Newer insulin analogues and agents may enhance treatment efficacy.
  • Further research is needed to optimize diabetes care during critical times.

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