Perioperative management of Diabetes Mellitus

Perioperative management of Diabetes Mellitus

SH. ALAMDARI, MD

ASSOCIATE PROFESSOR OF ENDOCRINOLOGY AND METABOLISM

SBMU, RIES

Objectives

1. General considerations
2. Key elements of the initial assessment
3. Preoperative laboratory investigations
4. Effect of surgery on glucose control
5. General Goals of Glycemic Control
6. Glycemic targets
7. Early Perioperative Phase
8. Scenario 1: Type 2 diabetes treated with diet alone
9. Scenario 2: Type 2 diabetes treated with oral hypoglycemic agents
10. Scenario 3: Type 1 or insulin treated type 2 diabetes
11. Timing of procedure
12. Scenario 4: Long and complex procedures for type 1 or insulin treated type 2 diabetes
13. Glucose insulin potassium infusion
14. Separate insulin and glucose intravenous solutions
15. Late Postoperative Phase
16. Sliding Scale Development
17. Glucocorticoid therapy
18. Hyperalimentation
19. Glycemic control and
    intensive insulin therapy in critical illness