Perioperative glucose control in the diabetic or nondiabetic patient.
Patients with diabetes are more likely to undergo surgery than nondiabetics, and maintaining glycemic control in subjects with diabetes can be challenging during the perioperative period. Surgery in diabetic patients is associated with longer hospital stay, higher health care resource utilization, and greater perioperative mortality. In addition, several observational and interventional studies have indicated that hyperglycemia is associated with adverse clinical outcomes in surgical and critically ill patients. This paper reviews the pathophysiology of hyperglycemia during trauma and surgical stress and will provide practical recommendations for the preoperative, intraoperative, and postoperative care of diabetic patients.
Smiley
Dawn D
DD
Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA 30303, USA.
Umpierrez
Guillermo E
GE
D001786:Blood Glucose / Q000032:analysis*; D015897:Comorbidity; D001026:Coronary Artery Bypass; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage; D007432:Intraoperative Period; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D051437:Renal Insufficiency / Q000453:epidemiology; D013514:Surgical Procedures, Operative; D013530:Surgical Wound Infection / Q000503:physiopathology; D014945:Wound Healing / Q000502:physiology
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007004:Hypoglycemic Agents; D007328:Insulin