Diabetes in pediatric ambulatory surgical patients.
Pediatric patients with insulin-dependent diabetes mellitus (IDDM) are at significant risk for blood glucose alterations when undergoing surgery. This risk results from a change in routine; change in or lack of perioperative insulin; and physical and emotional stress related to the surgical procedure, surroundings, parental anxiety, and surgical pain. This article reviews the physiological dynamics of IDDM and the stress response; perioperative insulin dosing; and preoperative, intraoperative, and postoperative insulin and fluid management. Careful planning and effective communication by health care professionals with the patient and family is imperative to ensure a normoglycemic metabolic state preoperatively and throughout the postoperative and convalescent phase of recovery.
Kirschner
R M
RM
D000556:Ambulatory Surgical Procedures; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000451:nursing* / Q000601:surgery*; D006801:Humans; D010371:Pediatric Nursing; D011182:Postoperative Care; D011300:Preoperative Care