title: Clinical recommendations in the management of the patient with type 1 diabetes on insulin pump therapy in the perioperative period: a primer for the anaesthetist.
abstract: Insulin pump therapy is increasingly common in patients with type 1 diabetes. Many of these patients will require surgery at some point in their lifetime. Few doctors will have experience of managing these patients, and little evidence exists to assist in the development of guidelines for patients with insulin pump therapy, undergoing surgery.It is clear that during emergency surgery insulin pump therapy is not appropriate and should be discontinued, but patients undergoing some elective surgery can and should continue insulin pump therapy, without any adverse effect on their blood sugar control, or on the outcome of their surgery. Individual hospitals need to formalize guidance on the management of patients receiving continuous subcutaneous insulin therapy, to allow patients the choice to continue their therapy during surgery. This expert opinion presents anaesthetists with a suggested clinical framework to help facilitate continued insulin pump therapy, during elective surgery and into the postoperative period.
authors.affiliation: Department of Diabetes and Endocrinology, Royal Bournemouth Hospital, Bournemouth, UK.
authors.forename: H
authors.initials: H
authors.lastname: Partridge
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Perkins
authors.affiliation: Department of Critical Care, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: S
authors.initials: S
authors.lastname: Mathieu
authors.affiliation: Department of Diabetes and Endocrinology, Royal Bournemouth Hospital, Bournemouth, UK adnicholls@doctors.org.uk.
authors.forename: A
authors.initials: A
authors.lastname: Nicholls
authors.affiliation: Department of Critical Care, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: K
authors.initials: K
authors.lastname: Adeniji
mesh_terms: D000758:Anesthesia / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D059035:Perioperative Period
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: diabetes mellitus, type 1; insulin infusion systems; surgery