title: Diabetes mellitus: anaesthetic management.
abstract: As the incidence of diabetes mellitus continues to increase in the United Kingdom, more diabetic patients will present for both elective and emergency surgery. Whilst the underlying pathophysiology of type 1 and type 2 diabetes differs, there is much good evidence that controlling the blood glucose to < or = [corrected] 10 mmol.l(-1) in the peri-operative period for both types of diabetic patients improves outcome. This should be achieved with a glucose-insulin-potassium regimen in all type 1 diabetics and in type 2 diabetics undergoing moderate or major surgical procedures. After surgery, a decrease in the catabolic hormone response resulting from good analgesia and the avoidance of nausea and vomiting should allow early re-establishment of normal glycaemic control.
authors.affiliation: Deaprtment of Anaesthesia and Intensive Care Medicine, St George's Hospital, London, UK. hroberts@sgul.ac.uk
authors.forename: H J
authors.initials: HJ
authors.lastname: Robertshaw
authors.forename: G M
authors.initials: GM
authors.lastname: Hall
mesh_terms: D000758:Anesthesia / Q000379:methods*; D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D019990:Perioperative Care / Q000379:methods*; D011188:Potassium / Q000008:administration & dosage
chemical_list: D001786:Blood Glucose; D007328:Insulin; C030396:glucose-insulin-potassium cardioplegic solution; D005947:Glucose; D011188:Potassium