Diabetes Mellitus

Abstract

Diabetes mellitus (DM) is a common chronic disorder associated with cardiovascular disease and microvascular complications, often necessitating surgical intervention. These patients are at an increased risk of perioperative infection and postoperative morbidity and mortality. The complex interplay of stress from surgery, anesthesia, and fasting, along with additional postoperative factors such as infection, altered nutritional intake, hyperalimentation, and emesis, can lead to labile blood glucose levels. There is a clear association between perioperative hyperglycemia and adverse clinical outcomes, although the exact mechanism(s) underlying this remains unclear. Perioperative DM management focuses on glycemic control. Substantial evidence indicates that the correction of hyperglycemia with insulin administration reduces complication rates and decreases mortality in cardiac and general surgery patients.