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DIABETIC MANAGEMENT
Insulin Regimens in Diabetic Patients
Insulin Regimen
Day Before Surgery
Day of Surgery
Insulin pump
No change; use "sick
day" or "sleep" basal
rates
No change; use "sick
day" or "sleep" basal
rates
Long-acting,
peakless insulins
75% of evening dose if
history of nocturnal or
morning hypoglycemia
is present
75% to 100% of morning dose, administered
upon arrival to the
facility
Intermediate-acting
insulins
No change in the day- 50% to 75% of morning
time dose; 75% of
dose, administered
evening dose if history upon arrival
of nocturnal or morning
hypoglycemia is present
Fixed combination
insulins
75% of evening dose if
history of nocturnal or
morning hypoglycemia
is present
50% to 75% of morning
dose of intermediateacting component;
neutral protamine
Hagedorn in place of
lispro-protamine
Short- and rapidacting insulin
No change
Hold the dose
Non-insulin injectables No change
Hold the dose
Adapted from the Society for Ambulatory Anesthesia's Consensus
Statement on Perioperative Blood Glucose Management in Diabetic
Patients Undergoing Ambulatory Surgery.
O C T O B E R 2012 | 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
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