Diabetes mellitus: anaesthetic management*

Abstract

SummaryAs the incidence of diabetes mellitus continues to increase in the United Kingdom, more diabetic patients will present for both elective and emergency surgery. Whilst the underlying pathophysiology of type 1 and type 2 diabetes differs, there is much good evidence that controlling the blood glucose to > 10 mmol.l )1 in the peri-operative period for both types of diabetic patients improves outcome. This should be achieved with a glucose-insulin-potassium regimen in all type 1 diabetics and in type 2 diabetics undergoing moderate or major surgical procedures. After surgery, a decrease in the catabolic hormone response resulting from good analgesia and the avoidance of nausea and vomiting should allow early re-establishment of normal glycaemic control.

Factores fisiopatológicos y metas terapéuticas perioperatorias que influyen en procedimientos quirúrgicos reconstructivos mediante colgajos en pacientes con Diabetes Mellitus

“…Los procedimientos quirúrgicos están relacionados con un aumento de la secreción de sustancias catabólicas junto con una deficiencia relativa de insulina, de esta forma los pacientes aun no siendo diabéticos serán hiperglucemiantes durante el perioperatorio 24 . Por otra parte, el reconocimiento de la hipoglucemia en pacientes diabéticos o en pacientes en riesgo de desarrollarla, representa un punto importante a tener presente en el período perioperatorio por todas las implicaciones que esta conlleva 25 .…”

Investigation of the effects of propofol and vitamin C administration on erythrocyte deformability in rats with streptozotocin-induced

“…In the recent two or three decades, the prevalence of diabetes mellitus (DM) has rapidly increased throughout the world, the estimation being that it will increase by 200 % in the next several decades (1)(2)(3)(4)(5). As a result, physicians will be encountered with an increasing population of diabetic patients undergoing anesthesia and surgery with serious complications, such as hypertension, ischemic heart disease in association with signifi cant increases in length of stay and mortality rates in hospital, as well as nephropathy, and autonomic neuropathy (1)(2)(3).…”

“…As a result, physicians will be encountered with an increasing population of diabetic patients undergoing anesthesia and surgery with serious complications, such as hypertension, ischemic heart disease in association with signifi cant increases in length of stay and mortality rates in hospital, as well as nephropathy, and autonomic neuropathy (1)(2)(3).…”

Effect of dexmedetomidine on erythrocyte deformability during ischemia-reperfusion injury of liver in diabetic rats

“…In the recent two or three decades, the prevalence of diabetes mellitus (DM) has rapidly increased throughout the world, with the estimation that it will increase by 200 % in the next several decades (1)(2)(3)(4). As a result, physicians will be encountered with an increasing population of diabetic patients undergoing anesthesia and surgery and also the patients may have serious complications, such as hypertension, ischemic heart disease in association with signifi cant increases in length of stay and mortality rates in hospital, as well as nephropathy, and autonomic neuropathy (1)(2)(3).…”

“…As a result, physicians will be encountered with an increasing population of diabetic patients undergoing anesthesia and surgery and also the patients may have serious complications, such as hypertension, ischemic heart disease in association with signifi cant increases in length of stay and mortality rates in hospital, as well as nephropathy, and autonomic neuropathy (1)(2)(3). Moreover, the diabetics have as much as two to three fold higher frequency of cardiovascular disorders and three times higher mortality rates in comparison to the healthy population (4).…”