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Positionspapier: Operation und Diabetes mellitus (Update 2019)

Position statement: surgery and diabetes mellitus (Update 2019)

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Zusammenfassung

Das vorliegende Positionspapier beschreibt die Sicht der Österreichischen Diabetes Gesellschaft hinsichtlich des perioperativen Managements von Patienten mit Diabetes mellitus auf Basis der verfügbaren wissenschaftlichen Evidenz. Dabei wird Bezug genommen auf die präoperative Begutachtung und Vorbereitung sowie auf die perioperative Stoffwechselkontrolle mittels oraler Antidiabetika und/oder injektabler Therapie (Insulin-/GLP-1-RA-therapie).

Summary

This position statement reflects the opinion of the Austrian Diabetes Association concerning the perioperative management of patients with diabetes mellitus based on the available scientific evidence. The paper covers necessary preoperative examinations from an internal/diabetological point of view as well as the perioperative metabolic control by means of oral antidiabetics and/or insulin therapy.

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Literatur

  1. Österr. Ges. f. Anästhesiologie, Reanimation und Intensivmedizin (ÖGARI). ÖGARI – Quellleitlinie zur präoperativen PatientInnenevaluierung (Juli 2011) inkl. Anamnesebogen ÖGARI vers 1.1.pdf. www.oegari.at. 2011. ARGE Präoperatives Patientenmanagement.

    Google Scholar 

  2. Meneghini LF. Perioperative management of diabetes: translating evidence into practice. Cleve Clin J Med. 2009;76(suppl. 4):53–9.

    Article  Google Scholar 

  3. Inzucchi SE. Management of hyperglycemia in the hospital setting. N Engl J Med. 2006;355:1903–11.

    Article  CAS  Google Scholar 

  4. Cheisson G, Jaqueminet S, Cosson E, et al. Perioperative management of adult diabetic patients. The rols of the diabetologist. Anaesth Crit Care Pain Med. 2018;37:S37–S29. https://doi.org/10.1016/j.accpm.2017.10.009.

    Article  PubMed  Google Scholar 

  5. Reddy P, Duggar B, Butterworth J. Blood glucose management in the patient undergoing cardiac surgery: a review. World J Cardiol. 2014;6:1209–17. https://doi.org/10.4330/wjc.v6.i11.1209.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Zhang Y, Theng Q‑J, Wang S, Zeng S‑X, Zhang Y‑P, Bai X‑J, Hou T‑Y. Diabetes is associated with increased risk of surgical infections: a meta-analysis of prospective cohort studies. Am J Infect Control. 2015; https://doi.org/10.1016/j.ajic.2015.04.003.

    Article  PubMed  Google Scholar 

  7. Martin ET, Kaye KS, Knott C, Nguyen H, Santarossa M, Evans R, Bertran E, Jaber L. Diabetes and risk of surgical site infection: a systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2015; https://doi.org/10.1017/ice.2015.249.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Zhang H, Yuan X, Osnabrugge RLJ, Meng D, Gao H, Zhang S, Rao C, Hu S, Zheng Z. Influence of diabetes mellitus on long-term clinical and ecomomic outcomes after coronary artery bypass grafting. Ann Thorac Surg. 2014;97:2073–80. https://doi.org/10.1016/j.athoracsur.2014.02.047.

    Article  PubMed  Google Scholar 

  9. Greco G, Ferket BS, D’Alessandr DA, Shi W, Horvath KA, Rosen A, Welsh S, Bagiella E, Neill AE, Williams DL, Greenberg A, Browndyke JN, Gillinov AM, Mayer ML, Keim-Malpass J, Gupta LS, Hohmann SF, Gelijns AC, O’Gara PT, Moskowitz AJ. Diabetes and the association of postoperative hyperglycemia with clinical and economic outcomes in cardiac surgery. Diabetes Care. 2016; https://doi.org/10.2337/dc15-1817.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Buchleitner AM, Martinez-Alonso M, Hernandez M, Sola I, Mauricio D. Perioperative glycaemic control for diabetic patients undergoing surgery. Cochrane Database Syst Rev. 2012; https://doi.org/10.1002/14651858.CD007515.pub2.

    Article  PubMed  Google Scholar 

  11. Underwood P, Askari R, Hurwitz S, Chamarthi B, Garg R. Preoperative A1c and clinical outcomes in patients with diabetes undergoing major noncardiac surgical procedures. Diabetes Care. 2014;37:611–6. https://doi.org/10.2337/dc13.1329.

    Article  CAS  PubMed  Google Scholar 

  12. Griesdale DEG, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ. 2009;180(8):821–7.

    Article  Google Scholar 

  13. Hermanides J, Qeva E, Preckel B, Bilotta F. Perioperative hyperglycaemia and neurocognitive outcoms after surgery: a systematic review. Minerva Anestesiol. 2018; https://doi.org/10.23736/S0375-9393.18.12400-X.

    Article  PubMed  Google Scholar 

  14. Magee F, Bailey M, Pilcher DV, et al. Early glycemia and mortality in critically ill septic patients: interaction with insulin-treated diabetes. J Crit Care. 2018;45:170–7. https://doi.org/10.1016/jcrc.2018.03.012.

    Article  CAS  PubMed  Google Scholar 

  15. Haga KK, et al. The effect of tight glycaemic control, during and after cardiac surgery, on patient mortality and morbidity: a systematic review and meta-analysis. J Cardiothorac Surg. 2011;6:3.

    Article  Google Scholar 

  16. Yong PH, Weinberg L, Torkamani N, et al. The presence of diabetes and higher HbA1c are independently associated with adverse outcomes after surgery. Diabetes Care. 2018;41:1172–9. https://doi.org/10.2337/dc17-2304.

    Article  PubMed  Google Scholar 

  17. Newman JD, Wilcox T, Smilowitz NR, Berger JS. Influence of diabetes on trends in perioperative cardiovascular events. Diabetes Care. 2018;41:1268–74. https://doi.org/10.2337/dc17-2046.

    Article  PubMed  Google Scholar 

  18. Critchley JA, Carey IM, Harris T, et al. Glycemic control and risk of infections among people with type 1 or type 2 diabetes in a large primary care cohort study. Diabetes Care. 2018;41:2127–35. https://doi.org/10.2337/dc18-0287.

    Article  CAS  PubMed  Google Scholar 

  19. Peters AL, Buschur EO, Buse JB, Cohan P, Diner JC, Hirsch IB. Euglycemic diabetic ketoacidosis. A potential complication of treatment with sodium-glucose cotransporter 2 inhibition. Diabetes Care. 2015;38:1687–93. https://doi.org/10.2337/dc15-0843.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Bonora BM, Avogara A, Fadini GP. Sodium-glucose co-transporter-2 inhibitors and diabetic ketoacidosis: an updated review of the literature. Diabetes Obes Metab. 2018;20:25–33. https://doi.org/10.1111/dom.13012.

    Article  CAS  PubMed  Google Scholar 

  21. Nassar AA, et al. Insulin pump therapy in patients with diabetes undergoing surgery. Endocr Pract. 2011;29:1–22.

    Google Scholar 

  22. Friedell ML, Van Way CW 3rd, Freyberg RW, Almenoff PL. β‑blockade and operative mortality in noncardiac surgery: harmful or helpful. JAMA Surg. 2015;150:658–63. https://doi.org/10.1001/jamasurg.2015.86.CrossRefPubMedGoogle.

    Article  PubMed  Google Scholar 

  23. Barakat AF, Saad M, Abuzaid A, Mentias A, Mahmoud A, Elgendy IY. Perioperative statin therapy for patients undergoing coronary artery bypass grafting. Ann Thorac Surg. 2015; https://doi.org/10.1016/j.athoracsur.2015.09.070.

    Article  Google Scholar 

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Correspondence to Peter Fasching.

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P. Fasching, J. Huber, M. Clodi, H. Abrahamian und B. Ludvik geben an, dass kein Interessenkonflikt besteht.

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Fasching, P., Huber, J., Clodi, M. et al. Positionspapier: Operation und Diabetes mellitus (Update 2019). Wien Klin Wochenschr 131 (Suppl 1), 212–217 (2019). https://doi.org/10.1007/s00508-019-1459-8

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