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Evidence-based Guidelines for Perioperative Management of Diabetes in Cardiac and Vascular Surgery

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Abstract

Background

Management of patients with hyperglycaemia undergoing vascular and cardiac surgery is important, with mounting evidence that hyperglycaemia in this setting is associated with worse outcomes. Evidence-based guidelines for the management of these patients have been limited.

Methods/Results

Our institution was aware of the lack of standardization of care in this growing population group and formed a multidisciplinary guideline development group to develop evidence-based guidelines to standardize the perioperative management of hyperglycaemia.

Conclusion

This series of articles outlines the process of developing evidence-based guidelines and the recommendations for perioperative management of patients with hyperglycaemia and diabetes undergoing cardiac and vascular surgery at our institution.

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Abbreviations

ADA:

American Diabetes Association

BSL:

Blood sugar level

CABG:

Coronary artery bypass grafting

CVVHDF:

Continuous veno-venous haemodialysis and filtration

CII:

Continuous insulin infusion

DNE:

Diabetes Nurse Educator

FBG:

Fasting blood glucose

eGFR:

Estimated glomerular filtration rate

GDG:

Guideline Development Group

GIK:

Potassium, Insulin and glucose infusion

HbA1c:

Glycosylated haemoglobin

ICU:

Intensive care unit

IFG:

Impaired fasting glucose

IGT:

Impaired glucose tolerance

NHMRC:

National Health and Medical Research Council

OGTT:

Oral glucose tolerance test

RBG:

Random blood glucose

TPN:

Total parenteral nutrition

WHO:

World Health Organisation

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Disclosure

Dr. Wong has received honoraria from Sanofi Aventis, Novo Nordisk, and Lilly Pharmaceuticals for providing educational sessions.

Author information

Authors and Affiliations

  1. Diabetes and Research Unit, Dandenong Hospital, Southern Health, 135 David Street, Dandenong, VIC, 3175, Australia

    Jennifer Wong

  2. The George Institute for International Health, Sydney, NSW, Australia

    Sophia Zoungas

  3. Monash School of Public Health and Preventive Medicine, Monash Institute of Health Services Research, Clayton, VIC, Australia

    Sophia Zoungas

  4. Intensive Care Unit, Southern Health, Victoria, Australia

    Chris Wright

  5. Diabetes and Research Unit, Southern Health, Victoria , Australia

    Helena Teede

  6. Monash Institute of Health Services Research, Jean Hailes’ Womens Health Research Group, Melbourne , Australia

    Helena Teede

Authors
  1. Jennifer Wong
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  2. Sophia Zoungas
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  3. Chris Wright
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  4. Helena Teede
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Corresponding author

Correspondence to Jennifer Wong.

Additional information

This study was conducted on behalf of the Southern Health Peri-operative Diabetes Management Guideline Group.

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Wong, J., Zoungas, S., Wright, C. et al. Evidence-based Guidelines for Perioperative Management of Diabetes in Cardiac and Vascular Surgery. World J Surg 34, 500–513 (2010). https://doi.org/10.1007/s00268-009-0380-0

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  • DOI: https://doi.org/10.1007/s00268-009-0380-0

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