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Diabetes Mellitus

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Abstract

Perioperative hyperglycemia increases the risk of infection and other complications. Perioperative control of hyperglycemia with insulin has been shown to nullify this increase even in patients not previously diagnosed as having diabetes (Frisch A, et al. Diabetes Care. 33:1783–8, 2010; Pomposelli JJ, et al. J Parenter Enteral Nutr. 22(2):77–81, 1998; Dellinger EP. Infect Control Hosp Epidemiol. 22:604–6, 2001; Inzucchi SE. N Engl J Med. 355(18):1903–11, 2006; Ramos M, et al. Ann Surg. 248:585–91, 2008; Moghissi ES, et al. Endocrinol Pract. 15(4):1–17, 2009; Kwon S, et al. Ann Surg. 257(1):8–14, 2013; Umpierrez GE, et al. Diabetes Care. 34:256–261, 2011; Kiran RP, et al. Ann Surg. 258(4):599605, 2013). Basal insulin therapy is key to good control, so think in terms of BASAL, BOLUS, and CORRECTION insulin (B-B-C), as shown in Table 13.1. The traditional practice of using only a “sliding scale” for insulin therapy should be abandoned.

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Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA

    Nason P. Hamlin M.D. & Kara J. Mitchell M.D.

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  1. Nason P. Hamlin M.D.
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  2. Kara J. Mitchell M.D.
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Correspondence to Nason P. Hamlin M.D. .

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Editors and Affiliations

  1. Division of General Internal Medicine Department of Medicine, University of Washington Medical Center, Seattle, WA, USA

    Molly Blackley Jackson , Somnath Mookherjee  & Nason P. Hamlin ,  & 

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Hamlin, N.P., Mitchell, K.J. (2015). Diabetes Mellitus. In: Jackson, M.B., Mookherjee, S., Hamlin, N.P. (eds) The Perioperative Medicine Consult Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-09366-6_13

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  • DOI: https://doi.org/10.1007/978-3-319-09366-6_13

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