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Review
. 2023 Aug;131(2):242-252.
doi: 10.1016/j.bja.2023.02.039. Epub 2023 Apr 13.

Current practice in the perioperative management of patients with diabetes mellitus: a narrative review

Kieran Crowley  1 , Pádraig Ó Scanaill  2 , Jeroen Hermanides  3 , Donal J Buggy  4
Affiliations
Review

Current practice in the perioperative management of patients with diabetes mellitus: a narrative review

Kieran Crowley et al. Br J Anaesth. 2023 Aug.

Abstract

The prevalence of diabetes is increasing, and patients with diabetes mellitus have both an increased likelihood of requiring surgery and of developing postoperative complications when they do. We summarise available evidence underpinning current guidelines on preoperative assessment and optimisation, perioperative management of prescribed insulin and oral hypoglycaemic medication, intraoperative glycaemic control, and postoperative patient care.

Keywords: diabetes mellitus; insulin; oral hypoglycaemic agent; postoperative complications; surgery.

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Conflict of interest statement

None of the other authors have any conflict of interest.

Figures

Fig 1
Fig 1
Guideline care pathway for the perioperative management of patients with diabetes mellitus (Reproduced with permission from the Centre for Perioperative Care; https://cpoc.org.uk/sites/cpoc/files/documents/2023-02/CPOC-Diabetes-Guideline-Updated2022_0.pdf; accessed 7 February 2023). CBG, capillary blood glucose; DrEaMing, drinking, eating, and mobilising; HbA1c, haemoglobin A1c; T1DM, type 1 diabetes mellitus.
See this image and copyright information in PMC

References

    1. International Diabetes Federation . 10th edn. IDF; Brussels, Belgium: 2021. IDF diabetes atlas.
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    1. Clement S., Braithwaite S.S., Magee M.F., et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27:553–591. - PubMed
    1. Fowler A.J., Wahedally M.A.H., Abbott T.E.F., et al. Death after surgery among patients with chronic disease: prospective study of routinely collected data in the English NHS. Br J Anaesth. 2022;128:333–342. - PubMed
    1. Centre for Perioperative Care (CPOC) 2021. Guideline for perioperative care for people with diabetes mellitus undergoing elective and emergency surgery.https://www.cpoc.org.uk/sites/cpoc/files/documents/2021-03/CPOC-Guidelin... Available from.

MeSH terms