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ANESTHESIA ALERT
Girish P. Joshi, MBBS, MD, FFARCSI
Are You Ready to Manage Diabetic Patients?
Expect to see more of them. Here are 8 tips for glycemic control.
N
early 10% of
the U.S.
population
now has diabetes,
and the American
Diabetes Association
estimates another
30% is pre-diabetic,
BLOOD SUGAR DILIGENCE Before surgery, determine the patient's level
of glycemic control based on blood glucose levels and, ideally, HbA1c.
making it likely you'll
encounter diabetic patients with greater frequency. We know surgical stress
response can lead to short-term resistance to insulin, which in turn causes
hyperglycemia. During surgery, hyperglycemia can cause dehydration, fluid
shifts, electrolyte abnormalities, a predisposition to infection and impaired
wound healing. For patients undergoing major surgery, these occurrences may
be associated with increased perioperative morbidity and mortality. While insufficient evidence exists to provide strong recommendations regarding glycemic
control specifically for outpatient surgery, here are steps we can take to ward
off diabetic complications.
1
Pre-operative screening
Determine the following pre-operatively:
• level of glycemic control based on blood glucose levels and, ideally, HbA1c;
2
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2012
