Management of Diabetes Mellitus in Surgical Patients

Dagogo‐Jack, Samuel; Alberti, K. G. M. M.

doi:10.2337/diaspect.15.1.44

Cited by 83 publications

(54 citation statements)

References 30 publications

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“…Coronary artery bypass grafting, appendectomy, cholecystectomy, bariatric surgery, laparotomy, abscess drainage, embolectomy and lower extremity amputation are the most commonly performed procedures in this population. Although major procedures such as coronary artery bypass grafting have additional risks, minor interventions can be associated with unwanted surgical and anaesthetic outcomes (16).…”

Section: Discussionmentioning

confidence: 99%

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Are there any effects of Sevoflurane and Desflurane anaesthesia on blood glucose levels in acute hyperglycemic diabetic rats?

Dikmen¹,

Arpacı²,

Kalaycı³

et al. 2016

BLL

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AIM: The aim of this study was to investigate blood glucose level of desfl urane and sevofl urane on blood glucose in diabetic rats undergoing acute hyperglycemia. MATERIALS AND METHODS: In this study, 30 male Wistar albino rats were included. Diabetes was induced by a single IP injection of streptozotocin. After the effects of chronic diabetes encountered, diabetic rats were randomly assigned into diabetic control (group DC), diabetic hyperglycemia group (group DH), diabetic hyperglycemia group with desfl urane (group DH-D), and diabetic hyperglycemia group with sevofl urane (group DH-S) groups. The normoglycemic groups received an IP injection of the same amount of saline. Hyperglycemic diabetic rats were anaesthetized by desfl urane 6 % or sevofl urane 2 % at a dose, by which minimal alveolar concentration (MAC) for rats would be one. The drugs were given for 4 hours within 100 % oxygen at a rate of 6 L.min -1 . One hour after cessation of inhalation anesthesia, blood glucose levels were determined at 1st, 4th and 24th hours. 24 hours after the anaesthesia. RESULTS: Serum glucose was detected to be signifi cantly lower in Group C, when compared to Groups DC, DH, DH-D and DH-S (p = 0.002, p = 0.001, p = 0.002, p = 0.003, respectively). Blood glucose levels in the diabetic groups were similar at the end of 6 weeks period, after hyperglycemia and anaesthesia induction. CONCLUSION: We found out that sevofl urane and desfl urane administrations in hyperglycemic rats were both related with insignifi cant blood glucose level increase at early post anaesthesia period and at post anaesthesia 24th hours. We still think that patients undergoing anaesthesia protocols with acute hyperglycemia need relatively longer follow up periods (Tab. 1, Ref. 28). Text in PDF www.elis.sk.

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Section: Discussionmentioning

confidence: 99%

“…So precautions have to be done, any impaired glucose level with blood electrolytes, signs of dehydration and acid-base derangements have to be identifi ed before surgery. When identifi ed once, insulin therapy with neutralization of dextrose solutions, correction of acid base disorders and electrolyte imbalances have to be treated (16).…”

Section: Discussionmentioning

confidence: 99%

Are there any effects of Sevoflurane and Desflurane anaesthesia on blood glucose levels in acute hyperglycemic diabetic rats?

Dikmen¹,

Arpacı²,

Kalaycı³

et al. 2016

BLL

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“…En pacientes tratados con insulina de acción prolongada, esta se debe suspender varios días previos a la cirugía y sustituirla con insulina de acción intermedia o múltiples aplicaciones de insulina de acción rápida en el día más insulina de acción intermedia en la noche; este régimen se puede continuar hasta horas previas a la cirugía. Si la cirugía se realiza en pacientes tratados con insulina de acción intermedia y se programa en la mañana, se debe administrar la mitad de la dosis total de insulina 40 .…”

Section: Período Preoperatoriounclassified

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

Alvear

et al. 2017

revmed

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Artículo recibido el 12 de Junio de 2016 y aceptado para publicación el 16 de Noviembre de 2016 RESUMEN Introducción: la diabetes mellitus es considerada un factor de riesgo para complicaciones locales y fracaso quirúrgico en cirugías reconstructivas mediante el uso de colgajos debido a las alteraciones en el proceso de cicatrización propias de este patología. Objetivo: hacer una revisión de la literatura disponible sobre los factores fisiopatológicos que influyen en los resultados posquirúrgicos a corto, mediano y largo plazo en la población diabética, así como de las metas terapéuticas perioperatorias asociadas a mayores tasas de éxito. Metodología de Búsqueda: se realizó búsqueda en las bases de datos PUBMED, MEDLINE Y SCIELO, mediante el gestor de búsqueda utilizando los términos: "Period perioperative", "Reconstructive surgical procedures", "Surgical flaps", "Diabetes mellitus", obteniendo un total de 160 artículos de revistas en línea, de los cuales se seleccionaron 50. Resultados: la realización de colgajos en pacientes con diabetes mellitus se asocia a mayor riesgo de fracaso y complicaciones, las cuales disminuyen considerablemente si se realiza un estricto manejo perioperatorio enfocado en metas. Conclusiones: la diabetes mellitus causa alteraciones en la respuesta inflamatoria, disfunción microvascular y mayor estrés oxidativo, lo cual se ve reflejado en un proceso de cicatrizacion anormal, generando mayores tasas de infeccion y perdidas de colgajos; un estricto manejo peri operatorio guiado por metas logra disminuir las complicaciones y aumentar el exito quirurgico. Pathophysiologic factors and perioperative therapeutic goals that affect reconstructive surgical procedures with flaps in patients with Diabetes MellitusABSTRACT Introduction: diabetes mellitus is considered a risk factor for local complications and surgical failure in reconstructive surgeries, mainly in flaps due to the fact that it causes alterations in the cicatrization process. Objective: to review the available literature on the pathophysiological factors that influence the short-, medium-and long-term results in the diabetic population, the perioperative therapeutic goals associated with higher success rates, and to establish a baseline protocol for the perioperative management of these patients. Searching methodology: we searched the PUBMED, MEDLINE and SCIELO databases using the search terms "Period

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“…Electrolyte monitoring and potassium administration may be necessary in longer cases. 1 The following points bear repeat mention: (1) type 1 diabetes mellitus is characterized by a lack of insulin production, whereas type 2 is characterized by a combination of insulin resistance and relative insulin insufficiency. (2) Surgical stress leads to the release of catecholamines, glucagon, and cortisol.…”

mentioning

confidence: 99%

Perioperative Insulin Dosing in Diabetic Patients Undergoing Outpatient Upper Extremity Surgery

Ablove

2010

The Journal of Hand Surgery

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Management of Diabetes Mellitus in Surgical Patients

Cited by 83 publications

References 30 publications

Are there any effects of Sevoflurane and Desflurane anaesthesia on blood glucose levels in acute hyperglycemic diabetic rats?

Are there any effects of Sevoflurane and Desflurane anaesthesia on blood glucose levels in acute hyperglycemic diabetic rats?

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

Perioperative Insulin Dosing in Diabetic Patients Undergoing Outpatient Upper Extremity Surgery

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