title: Coronary artery bypass grafting: a precipitating factor for perioperative diabetic ketoacidosis.
abstract: Non-Insulin Dependent Diabetes Mellitus (NIDDM) is a common disease entity in patients with Coronary Artery Disease (CAD). Diabetic Ketoacidosis (DKA) is not only one of the major complications of Diabetes Mellitus but also a significant challenging clinical entity for the patients undergoing any elective or emergency surgery. Coronary Artery Bypass Grafting (CABG) being done in a patient with DKA has not been reported. We are presenting a rare case with DKA in whom CABG was carried out in a hospital devoted exclusively to cardiac cases. Insulin was given in very large doses as a part of therapeutic regimen and the outcome was favorable. This report concludes that if a patient undergoing urgent cardiac surgery incidentally develops DKA after induction of anesthesia, then the operation can be carried out provided DKA is managed aggressively. Also, major stress factors like cardio pulmonary bypass (CPB) and hypothermia should be avoided and care should be taken to avoid cerebral edema.
authors.affiliation: Regional Hospital of Scranton, The Commonwealth Medical College Scranton, PA, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Sehgal
authors.forename: Sukhminder
authors.initials: S
authors.lastname: Jit Singh Bajwa
authors.forename: Abbas
authors.initials: A
authors.lastname: Kitabchi
keywords: Coronary Artery Bypass Grafting; Diabetes Mellitus; Diabetic Ketoacidosis; Insulin