title: Guidelines for application of continuous subcutaneous insulin infusion (insulin pump) therapy in the perioperative period.
abstract: Case reports indicate that diabetes patients receiving outpatient insulin pump therapy have been allowed to continue treatment during surgical procedures. Although allowed during surgery, there is actually little information in the medical literature on how to manage patients receiving insulin pump therapy during a planned surgical procedure. A multidisciplinary work group reviewed current information regarding the use of insulin pumps in the perioperative period. Although the work group identified safety issues specific to surgical scenarios, it believed that with the use of standardized guidelines and a checklist, continuation of insulin pump therapy during the perioperative period is feasible. A sample set of protocols have been developed and are summarized. A policy outlining clear procedures should be established at the institutional level to guide physicians and other staff if the devices are to be employed during the perioperative period. Additional clinical experience with the technology in surgical scenarios is needed, and consensus should be developed for insulin pump use in the perioperative phases of care.
authors.affiliation: Division of Endocrinology, Mayo Clinic, Scottsdale, Arizona 85259, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Boyle
authors.forename: Karen M
authors.initials: KM
authors.lastname: Seifert
authors.forename: Karen A
authors.initials: KA
authors.lastname: Beer
authors.forename: Heidi A
authors.initials: HA
authors.lastname: Apsey
authors.forename: Adrienne A
authors.initials: AA
authors.lastname: Nassar
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Littman
authors.forename: Janice M
authors.initials: JM
authors.lastname: Magallanez
authors.forename: Richard T
authors.initials: RT
authors.lastname: Schlinkert
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Stearns
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hovan
authors.forename: Curtiss B
authors.initials: CB
authors.lastname: Cook
mesh_terms: D057189:Checklist / Q000379:methods / Q000592:standards; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems / Q000592:standards / Q000706:statistics & numerical data*; D059035:Perioperative Period / Q000379:methods; D017410:Practice Guidelines as Topic; D059039:Standard of Care / Q000331:legislation & jurisprudence
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin