Avoidance of Surgical Hyperglycemia in Diabetic Patients

Woodruff, Robert E.

doi:10.1001/jama.1980.03310020042026

Cited by 8 publications

(1 citation statement)

References 7 publications

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“…This trend was consistent across 4 of the 5 major medical journals that we assessed, in which we observed an overall increase in the proportion of titles that made use of a patient noun that is independent of a disease process. Whereas it was common in the 1970s and 1980s to describe diabetic patients or guidelines for the diabetic , we found no instances of the word diabetic being used as a noun or adjective describing a patient in JAMA from 2011 through 2015. Instead, the tendency has been to describe patients with diabetes or adults with diabetes .…”

Section: Discussionmentioning

confidence: 99%

Trends in the Use of Common Words and Patient-Centric Language in the Titles of Medical Journals, 1976-2015

2019

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Key Points Question Does the language of medicine in academic journals indicate whether the culture of clinical investigation has shifted toward patient centeredness? Findings In this qualitative study of medical language of 302 293 articles from 5 premier medical journals, use in the last 40 years has changed to reflect a shift from individuals to populations, a separation of patient and disease, and an increase in patient-centric titles. Meaning Whereas medical language previously emphasized treatments and disease processes, the trend during the last 40 years has been to separate patients from their disease and to emphasize the patient rather than characterize patients by their disease.

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Section: Discussionmentioning

confidence: 99%

Trends in the Use of Common Words and Patient-Centric Language in the Titles of Medical Journals, 1976-2015

2019

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The Care of the Diabetic Patient During Surgery

Gill

Alberti

2004

International Textbook of Diabetes Mellitus

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Most diabetic patients will require surgery at some time in their lives, and this presents problems for glycemic control. Surgery involves a period of starvation, and also the metabolic response to trauma includes counterregulatory hormone hypersecretion (e.g., adrenaline, cortisol, etc.), which opposes insulin action. The major factor influencing the management of diabetes during surgery is assessment of the patient's insulin reserves. Thus, those on insulin treatment (whether they are true type 1, or insulin‐treated type 2 patients) should be assumed to have little or no endogenous insulin reserves, and a system of continuous insulin and glucose delivery is necessary. Those not on insulin, however, clearly have their own insulin reserves and, provided they have reasonable preoperative glycemic control, for all but major surgery simple glycemic observation is usually all that is needed. Delivery of insulin and glucose may be by “separate lines” (intravenous (IV) glucose infusion with a separate IV insulin pump), or by a combined glucose–potassium–insulin infusion. The latter is easier to manage on lower‐staffed general wards, and the former is particularly flexible and suitable for critical care situations with more metabolically unstable patients and higher levels of staffing. Whichever system is used, patients must have regular blood glucose and plasma electrolyte monitoring, with appropriate insulin adjustments to maintain good glycemic control. With good preoperative control and assessment, and well organized and appropriate perioperative management, the risks of surgery in diabetic patients should in most cases be similar to nondiabetic rates.

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Preoperative evaluation

Kroenke¹

1987

J Gen Intern Med

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Avoidance of Surgical Hyperglycemia in Diabetic Patients

Cited by 8 publications

References 7 publications

Trends in the Use of Common Words and Patient-Centric Language in the Titles of Medical Journals, 1976-2015

Trends in the Use of Common Words and Patient-Centric Language in the Titles of Medical Journals, 1976-2015

The Care of the Diabetic Patient During Surgery

Preoperative evaluation

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