Current Diabetes Reports

, Volume 12, Issue 1, pp 108–118

Management of Hyperglycemia During the Perioperative Period

Hospital Management of Diabetes (M Korytkowski, Section Editor)

DOI: 10.1007/s11892-011-0239-2

Cite this article as:
Pichardo-Lowden, A. & Gabbay, R.A. Curr Diab Rep (2012) 12: 108. doi:10.1007/s11892-011-0239-2

Abstract

Hyperglycemia is frequently encountered in the inpatient setting and is distinctly associated with poor clinical outcomes. Recent literature suggests an association between stringent glycemic control and increased mortality, thus keeping optimal glycemic targets a relevant subject of debate. In the surgical population, hyperglycemia with or without diabetes mellitus may be unrecognized. Factors contributing to hyperglycemia in the hospital include critical illness, use of certain drugs, use of enteral or parenteral nutrition, and variability in oral or nutritional intake as can occur when patients are prepared for procedures or surgery. A sensible approach to managing hyperglycemia in this population includes preoperative recognition of diabetes mellitus and risks for inpatient hyperglycemia. Judicious control of glycemia during the pre-, intra-, and postoperative time periods with avoidance of hypoglycemia mandates the need for a strategy for patient management that extend to time of discharge. We review the consequences of uncontrolled perioperative hyperglycemia, discuss current clinical guidelines and recent controversies, and provide practical tools for glycemic control in the surgical population.

Keywords

Perioperative glycemic controlInpatient hyperglycemiaDiabetic and nondiabetic populations

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Penn State College of Medicine, Penn State Hershey Diabetes and Obesity Institute, Division of Endocrinology, Diabetes and MetabolismHersheyUSA