title: Preprocedure and preoperative management of diabetes mellitus.
abstract: Appropriate management of diabetes mellitus before a procedure or operation is important for the prevention of hypo- and hyperglycemia in the periprocedural/perioperative period. This can significantly influence glucose levels after a procedure, which in turn affects outcomes. There is a paucity of prospective trials addressing algorithms to guide adjustment of oral diabetes medications and insulin prior to a procedure. Our institution has developed guidelines that allowed us to standardize the periprocedural process for glucose management across departments. This article describes our experience with guidelines, discusses salient features of medication management, and summarizes prospective trials and expert opinion to provide recommendations for clinicians to effectively manage glucose preprocedurally for their patients with diabetes.
authors.affiliation: Clinical Fellow, Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Bodnar
authors.forename: Roma
authors.initials: R
authors.lastname: Gianchandani
mesh_terms: D003920:Diabetes Mellitus / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage; D017410:Practice Guidelines as Topic; D011300:Preoperative Care
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D000069057:Insulin Detemir