title: [Perioperative management of diabetic patient].
abstract: The prevalence of diabetes is rising and diabetics may soon represent more than 5% of the world population. The type 2 diabetes is a major independent risk factor for coronary artery disease. The screening for silent myocardial ischemia (IMS) must be systematic. The autonomic dysfunction and the cardiac microcirculatory disorders are at risk of hypotension and hypothermia during anesthesia. After 10 years of diabetes duration the incidence of perioperative complications and of difficult intubation are increased. The neurological deficits related to anesthesia are associated with general anesthesia in 85% of cases. Particular care will be provided during the surgical procedure to avoid skin, muscular and neurologic cuts. In most cases, the regional anesthesia will be preferred to general anesthesia. To avoid hypoglycemia, blood glucose concentration less than 11 mmol.L(-1)(2g.L(-1)) seems a reasonable target during and after surgery.
authors: CHU de Nice, hôpital L'archet, service d'anesthésie-réanimation, 06200 Nice, France. carles.m@chu-nice.fr
authors: Michel
authors: M
authors: Carles
authors: Marc
authors: M
authors: Raucoules-Aimé
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D001341:Autonomic Nervous System / Q000503:physiopathology; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D048909:Diabetes Complications / Q000175:diagnosis / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology; D004198:Disease Susceptibility; D005215:Fasting; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007239:Infections / Q000209:etiology; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D007442:Intubation, Intratracheal; D007668:Kidney / Q000503:physiopathology; D019990:Perioperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D014945:Wound Healing
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents