Perioperative management of an adult diabetic patient for elective colorectal surgery

Abstract

Patients with diabetes mellitus are more likely to require admission to hospital for conditions other than the diabetes itself and are more likely to undergo colorectal surgery. The paper presents guidelines for the preoperative management in diabetic patients scheduled for elective colorectal surgeries. Colorectal cancer and diabetes are increasingly common diseases. A major colorectal surgery may affect metabolic control in diabetes. Surgical procedure, perioperative fasting and interruptions in therapy contribute to poor glycaemic control, which in turn is a significant factor increasing mortality, morbidity and the length of hospital stay among patients with diabetes. Minimising such effects may reduce the risk of adverse outcomes. An extended elective colorectal surgery should be postponed if possible in patients with poor preoperative glycaemic control (HbA1c ≥ 9%). The target range for the perioperative period is between 140 and 180 mg/dL. Hypoglycaemia should also be avoided. This paper presents preoperative management in adult patients with diabetes mellitus scheduled for elective colorectal surgery. Glycaemic control is a key aspect in the perioperative management. For minor surgeries, blood glucose should be monitored before and immediately after surgery in all patients.