Glycemic Management in the Operating Room: Screening, Monitoring, Oral Hypoglycemics, and Insulin Therapy

Duggan, Elizabeth W.; Chen, York

doi:10.1007/s11892-019-1277-4

Cited by 36 publications

(36 citation statements)

References 85 publications

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“…Iatrogenic or accidental (over)administration of antidiabetic medications including preoperative oral medications and insulins are potential causes of intraoperative hypoglycemia. Other causes of intraoperative hypoglycemia include, inappropriate blood glucose monitoring, drug errors, and interruption of enteral or parental nutrition[ 50 ].…”

Section: Intraoperative Management Of Diabetes Mellitusmentioning

confidence: 99%

Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery

Galway¹,

Chahar²,

Schmidt³

et al. 2021

WJD

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Prediabetes and diabetes are important disease processes which have several perioperative implications. About one third of the United States population is considered to have prediabetes. The prevalence in surgical patients is even higher. This is due to the associated micro and macrovascular complications of diabetes that result in the need for subsequent surgical procedures. A careful preoperative evaluation of diabetic patients and patients at risk for prediabetes is essential to reduce perioperative mortality and morbidity. This preoperative evaluation involves an optimization of preoperative comorbidities. It also includes optimization of antidiabetic medication regimens, as the avoidance of unintentional hypoglycemic and hyperglycemic episodes during the perioperative period is crucial. The focus of the perioperative management is to ensure euglycemia and thus improve postoperative outcomes. Therefore, prolonged preoperative fasting should be avoided and close monitoring of blood glucose should be initiated and continued throughout surgery. This can be accomplished with either analysis in blood gas samples, venous phlebotomy or point-of-care testing. Although capillary and arterial whole blood glucose do not meet standard guidelines for glucose testing, they can still be used to guide insulin dosing in the operating room. Intraoperative glycemic control goals may vary slightly in different protocols but overall the guidelines suggest a glucose range in the operating room should be between 140 mg/dL to 180 mg/dL. When hyperglycemia is detected in the operating room, blood glucose management may be initiated with subcutaneous rapid-acting insulin, with intravenous infusion or boluses of regular insulin. Fluid and electrolyte management are other perioperative challenges. Notably diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic state are the two most serious acute metabolic complications of diabetes that must be recognized early and treated.

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Section: Intraoperative Management Of Diabetes Mellitusmentioning

confidence: 99%

Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery

Galway¹,

Chahar²,

Schmidt³

et al. 2021

WJD

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“…General anesthesia is associated with increases in counterregulatory hormones and insulin resistance, which can increase insulin requirements (58,59). The responsibility for J o u r n a l P r e -p r o o f glucose management in the operating room will usually fall to the anesthesiologist using specific intraoperative glycemic management protocols targeting BG of 140-180 mg/dl (51,53).…”

Section: Intraoperative Periodmentioning

confidence: 99%

Inpatient Hyperglycemia and Transitions of Care: A Systematic Review

2021

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“…Hipoglisemi tespit edildiğinde intravenöz yol mevcut ise 25-50 ml %50 dekstroz uygulanmalı ve hedef değere ulaşana kadar kan şekeri takibi yapılmalıdır. İntravenöz yol olmadığında ise 1 mg glukagon subkutan olarak uygulanabilmektedir (15,51) .…”

Section: İntraoperatif Dönemunclassified

Peroperative Period with Diabetes Mellitus

Ceran¹,

Polat²

2020

jarss

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Diabetes mellitus en yaygın kronik hastalıklardan biridir. Ameliyat edilecek hastaların %25'i diabetes mellitus tanısı almış kişilerdir. Hiperglisemisi olan bireylerin peroperatif değerlendirilmesi hem anestezik yönetim hem de hastanın yaşam kalitesini belirleyecek önemdedir. Bu derlemede, diyabetin fizyopatolojisi, tanı kriterleri, farmakolojik ve peroperatif değerlendirilmesi ve yönetiminden söz edilmiştir.

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Glycemic Management in the Operating Room: Screening, Monitoring, Oral Hypoglycemics, and Insulin Therapy

Cited by 36 publications

References 85 publications

Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery

Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery

Inpatient Hyperglycemia and Transitions of Care: A Systematic Review

Peroperative Period with Diabetes Mellitus

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