A survey: perioperative diabetes medications and glucose control—time to re-examine management?

Brown, Russell E.; Siddiqui, Urooj; Paul, James

doi:10.1007/s12630-019-01311-0

Cited by 5 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We appreciate and share the enthusiasm expressed by the constructive comments 1 in response to our recent survey surrounding the perioperative management of glucose control. 2 We agree entirely with the points raised surrounding the limited, yet supporting, evidence for the perioperative continuation of dipeptidyl peptidase-4 inhibitors. We believe that the larger barrier remains educating perioperative team members, including anesthesiologists, of the benefits for the routine adoption of continuing oral glucose-lowering medications perioperatively.…”

Section: To the Editorsupporting

confidence: 67%

In reply: Regarding the survey on perioperative diabetes medications and glucose control

Brown

Siddiqui

Paul

2019

Can J Anesth/J Can Anesth

Self Cite

View full text Add to dashboard Cite

Section: To the Editorsupporting

confidence: 67%

In reply: Regarding the survey on perioperative diabetes medications and glucose control

Brown

Siddiqui

Paul

2019

Can J Anesth/J Can Anesth

Self Cite

View full text Add to dashboard Cite

“…29 Together, this supports the notion that the use of oral glucose-lowering medications may offer a viable alternative to improve perioperative glycemic control. 8,9,29 Our rodent data suggest that salsalate may offer a viable and powerful alternative to improve perioperative glucose control in addition to antiinflammatory and analgesic properties, 30 and warrants further clinical investigation. Salsalate has been reported to lower blood glucose by reducing insulin clearance.…”

Section: Discussionmentioning

confidence: 81%

“…8 Despite the apparent importance of perioperative hyperglycemia, its significance and consequences may be largely underappreciated clinically. 9 Importantly, patient characteristics implicated in the development of hyperglycemia include increased body mass index, which raises important questions about the impact of obesity given its high incidence worldwide. 4,8 The impact of volatile anesthetics on glucose and insulin metabolism have been described for more than a century.…”

mentioning

confidence: 99%

Sevoflurane-induced hyperglycemia is attenuated by salsalate in obese insulin-resistant mice

Desjardins

Smith

Steinberg

et al. 2021

Can J Anesth/J Can Anesth

Self Cite

View full text Add to dashboard Cite

Purpose Perioperative hyperglycemia is common and is associated with significant morbidity. Although patient characteristics and surgery influence perioperative glucose metabolism, anesthetics have a significant impact. We hypothesized that mice that were obese and insulinresistant would experience greater hyperglycemia in response to sevoflurane anesthesia compared with lean controls. We further hypothesized that sevoflurane-induced hyperglycemia would be attenuated by salsalate pretreatment. Methods Lean and obese male C57BL/6J mice were anesthetized with sevoflurane for 60 min with or without pre-treatment of 62.5 mgÁkg -1 salsalate. Blood glucose, plasma insulin, and glucose uptake into different tissues were measured. Results Under sevoflurane anesthesia, obese mice had higher blood glucose compared to lean mice. Increases in blood glucose were attenuated with acute salsalate pretreatment at 60 min under anesthesia in obese mice (mean ± standard error of the mean [SEM], delta blood glucose; vehicle 5.79 ± 1.09 vs salsalate 1.91 ± 1.32 mM; P = 0.04) but did not reach statistical significance in lean mice (delta blood glucose, vehicle 4.39 ± 0.55 vs salsalate 2.79 ± 0.71 mM; P = 0.10). This effect was independent of changes in insulin but associated with an approx. 1.7-fold increase in glucose uptake into brown adipose tissue (vehicle 45.28 ± 4.57 vs salsalate 76.89 ± 12.23 lmolÁg -1 tissueÁhr -1 ; P \ 0.001). Conclusion These data show that salsalate can reduce sevoflurane-induced hyperglycemia in mice. This indicates that salsalate may represent a new class of therapeutics that, in addition to its anti-inflammatory and analgesic properties, may be useful to reduce perioperative hyperglycemia. Re ´sumeÓbjectif L'hyperglyce´mie pe´riope´ratoire est fre´quente et est associe´e a `une morbidite´significative. Bien que les caracte´ristiques propres au patient et a`la chirurgie influencent le me´tabolisme pe´riope´ratoire du glucose, les anesthe´siques ont un impact significatif. Nous avons e´mis l'hypothe`se que l'hyperglyce´mie en re´ponse a`une anesthe´sie a`base de se´voflurane serait plus prononce´e

show abstract

“…The draft was developed based on a previously conducted survey. 7 The questions were open-ended wherever applicable. 8 ] and complied with the[ SURGE guidelines.…”

Section: Methodsmentioning

confidence: 99%

“…6 A recent survey conducted in Canada found that the practice variation is still there. 7 All this indicates that the scope for further refinement of the practice is still there. It is imperative to know the conventional methods being used in our countries and their limitations.…”

Section: Introductionmentioning

confidence: 99%

A multinational online survey on the current perioperative practice for the management of patients with diabetes mellitus: a descriptive study

Khan¹,

Karim²,

Sharma³

et al. 2022

Anaesth. pain intensive care

View full text Add to dashboard Cite

Background & Objective: Diabetes mellitus is widely prevalent and significantly impacts the perioperative outcome. We aimed to assess the perioperative practice for managing diabetes mellitus patients and variation across different establishments. Methodology: A questionnaire-based online survey was conducted for the present cross-sectional, multinational study; data collection followed a snowball method and was conducted from November 2020 to January 2021. Responses were presented in absolute number and percentage scale, and response rates among the subgroups were analyzed using Fisher’s exact test; p < 0.05 was considered significant. Results: Responses from 556 out of 637 from six South Asian Association for Regional Cooperation countries were analyzed. A considerable amount of practice variation was noted; variation increased as the invasiveness of surgery increased. Perioperative insulin administration strategy and case postponement based on blood sugar level differed between the teaching and non-teaching sectors and private and public sectors. However, a majority (64.8%) of the respondents did not favor postponing a case based on the glycosylated hemoglobin (HbA1c) level. Confusion and diverse opinions were present even for emergency cases, including postponement based on blood sugar. Conclusion: There is a wide variation in the perioperative practice for managing diabetes mellitus patients. The variation increases with the increasing invasiveness of surgery. Although there were similar practices between private versus public sectors and teaching versus non-teaching institutions, significant differences were noticed about case postponement, indicating that an authoritative guideline is the need of the hour. Key words: HbA1c level; Sugar, Cut-off; Sugar level; Anesthesia; Perioperative practice; Hyperglycemia Trial Registration: The study was an online survey and as per the clinical trial registry of India, it was not required to be registered. Citation: Karim HMR, Sharma A, Khan TH, Abayadeera AU, Alam MR. A multinational online survey on the current perioperative practice for the management of patients with diabetes mellitus: a descriptive study. Anaesth. pain intensive care 2022;26(1):382-390. DOI: 10.35975/apic.v26i3.1914 Received: April 27, 2021; Reviewed: October 11, 2021; Accepted: December 16, 2021

show abstract

A survey: perioperative diabetes medications and glucose control—time to re-examine management?

Cited by 5 publications

References 5 publications

In reply: Regarding the survey on perioperative diabetes medications and glucose control

In reply: Regarding the survey on perioperative diabetes medications and glucose control

Sevoflurane-induced hyperglycemia is attenuated by salsalate in obese insulin-resistant mice

A multinational online survey on the current perioperative practice for the management of patients with diabetes mellitus: a descriptive study

Contact Info

Product

Resources

About