Perioperative management of diabetes mellitus and hyperglycaemia

Abstract

Diabetes mellitus is the most common endocrine disorder affecting surgical patients; although it occurs in 10% of the general population it is seen in up to 25% of the surgical population. Historically, patients with diabetes undergoing surgery were deemed to be very high risk and were often denied the benefits of day surgery. The application of the integrated care pathway coupled with perioperative manipulation of patients’ drugs has transformed surgical care for people with diabetes. Despite these advances, harm from dysglycaemia is not infrequent. The challenge facing clinicians and patients is to further mitigate the harm from hypo- and hyperglycaemia.