Management of Diabetes Mellitus in Surgical Patients

  1. Samuel Dagogo-Jack, MD, FRCP and
  2. K. George M.M. Alberti, DPhil, PRCP

    Abstract

    In Brief

    Diabetes is associated with increased requirement for surgical procedures and increased postoperative morbidity and mortality. The stress response to surgery and the resultant hyperglycemia, osmotic diuresis, and hypoinsulinemia can lead to perioperative ketoacidosis or hyperosmolar syndrome. Hyperglycemia impairs leukocyte function and wound healing. The management goal is to optimize metabolic control through close monitoring, adequate fluid and caloric repletion, and judicious use of insulin.

    Footnotes

    • Samuel Dagogo-Jack, MD, FRCP, is a professor of medicine in the Division of Endocrinology, Diabetes and Metabolism at the University of Tennessee College of Medicine in Memphis. K. George M.M. Alberti, DPhil, PRCP, is president of the Royal College of Physicians in London, U.K. He is a professor of medicine at the University of Newcastle upon Tyne in Newcastle, U.K. and a professor of metabolic medicine at the Imperial College of London.

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