Preoperative management of diabetes mellitus: A comparative narrative review of the recommendations of three professional organizations with Hamad Medical Corporation guidelines

Abstract

Background: Diabetes mellitus (DM) is a prevalent condition that requires careful management in the perioperative setting to reduce surgical risks and optimize patient outcomes. The preoperative care of diabetic patients is complex because glucose control must be balanced with minimizing hypoglycemic or hyperglycemic events during surgery. A variety of diabetic medications such as insulin, dipeptidyl-peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, and biguanides such as metformin present unique challenges and considerations due to their different mechanisms, benefits, and potential adverse effects. In recent years, professional organizations have developed recommendations on the perioperative management of these therapies, although there remain some variations in guidelines related to medication cessation and dosage adjustments. Standardized protocols in preoperative DM care remain a topic of interest to ensure consistent and safe practices across healthcare settings, and further collaborative research efforts could provide clarity and consensus in managing this diverse patient population.

Objective: The objective of this study was to provide an overview of guidelines and practices to support healthcare professionals in delivering improved preoperative care for diabetic patients. This initiative aims to enhance surgical outcomes and minimize the occurrence of complications.

Methods: This is a comparative review that provides a systematic comparison of the similarities and differences in the guidelines and recommendations of three professional organizations along with Hamad Medical Corporation. All guidelines were from official websites including Hamad Medical Corporation.

Conclusion: Although the reviewed guidelines for the preoperative care of diabetes patients share some similarities, there are also a number of differences due to outdated data and expert opinions, and therefore differ in practices around the world. While the key elements are agreed upon, more research and global collaboration are needed to create consistent guidelines and improve patient outcomes.

Keywords: Diabetes mellitus, preoperative management, dipeptidyl peptidase-4 inhibitors, sodium–glucose cotransporter-2 inhibitors, glucagon-like peptide-1 agonists, guidelines.