How do we manage BGL in fasting preoperative patients?

How do we manage BGL in fasting preoperative patients?

If the fasting BGL has been relatively low (consistently less than 5.0mmol/l), the bed-time intermediate- or long-acting insulin dose can be reduced by 10% on the night before the procedure. Oral AHGs should be omitted on the morning of surgery.

What factors might contribute to elevated blood sugar in the perioperative period?

One key aspect of the perioperative management is glycemic control; the complex interplay of being nil per os (NPO) preoperatively, the operative procedure, anesthesia, and additional postoperative factors such as sepsis, disrupted meal schedules and altered nutritional intake, hyperalimentation, and emesis can lead to …

How is hyperglycemia treated before surgery?

Hyperglycemia (greater than 180 mg/dl, 10 mM) is treated with subcutaneous rapid-acting insulin analogs or with an IV infusion of regular insulin. Patients undergoing ambulatory surgery or procedures of short duration (less than 4-h operating room time) are often appropriate candidates for SC insulin treatment.

What is the significance of proper blood sugar management in post operative patients?

Substantial evidence indicates that correction of hyperglycemia with insulin administration reduces hospital complications and decreases mortality in cardiac5 and general surgery patients. However, optimal glucose management during the perioperative period is widely debated.

How do I control my blood sugar before surgery?

You must bring oral glucose gel with you in case your blood glucose level is low on the day of surgery. You can buy the gel in the diabetes supply section of the drug store. Ask your doctor how you should adjust your diabetes medications or insulin before surgery.

Do you hold insulin before surgery?

Rapid-acting insulins should be held the morning of surgery. Patients who take intermediate-acting insulins, such as NPH, should take their usual dose on the evening prior to surgery. If they will be skipping their evening meal, the dose should be reduced by 25%.

What means perioperative?

Listen to pronunciation. (PAYR-ee-AH-pruh-tiv) Around the time of surgery. This usually lasts from the time the patient goes into the hospital or doctor’s office for surgery until the time the patient goes home.

At what point does the preoperative period end?

2. The preoperative phase begins when the patient, or someone acting on the patient’s behalf, is informed of the need for surgery and makes the decision to have the procedure. This phase ends when the patient is transferred to the operating room bed.

Is preoperative and perioperative same?

The perioperative period is a term used to describe the three distinct phases of any surgical procedure, which includes the preoperative phase, the intraoperative phase, and the postoperative phase.

Is glucose management optimal during the perioperative period?

However, optimal glucose management during the perioperative period is widely debated.

What is the optimal glycemic target for perioperative diabetic ketoacidosis?

Although the optimal glycemic target remains unclear, a reasonable goal in the majority of perioperative patients is to maintain blood glucose in the range of 140 to 180 mg/dl with the intent of avoiding both hypoglycemia (under 70 mg/dl) and severe hyperglycemia (over 180 mg/dl).

What is the normal range for Perioperative hyperglycemia?

This article reports on the prevalence, diagnosis, and pathophysiology of perioperative hyperglycemia and provides a practical outline for the management of surgical patients with diabetes and hyperglycemia. During the fasting state, normal subjects maintain plasma glucose levels between 60 and 100 mg/dl (3.3 to 5.5 mM).

How important is preoperative glycemic control in the management of diabetes?

These studies indicate that poor preoperative glycemic control is associated with an increased rate of complications and reduced long-term survival after surgery. Optimizing preoperative glucose management may improve outcomes; however, no prospective randomized studies have determined the importance of preoperative control and clinical outcome.