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A survey: perioperative diabetes medications and glucose control—time to re-examine management?

  • Russell BrownEmail author
  • Urooj Siddiqui
  • James Paul
Correspondence
  • 67 Downloads

To the Editor,

Anesthesia and surgery induce a number of metabolic derangements particularly in those with type-2 diabetes (T2D).1-3 Hyperglycemia (blood glucose > 11 mmol/L) is associated with risks including increased surgical site infection, thromboembolism, and myocardial infarction.1,2 Lowering glucose by even 1 mmol·L−1 is reported to reduce surgical site infections.4 Canadian population trends suggest we are increasingly likely to care for hyperglycemic patients perioperatively; accordingly, best management practices should be investigated and developed.

Following institutional ethical approval, we surveyed 2,415 practicing members of the Canadian Anesthesiologists Society with a six-question survey designed to assess practice patterns regarding perioperative diabetes management (eTable, full survey available as Electronic Supplementary Material). The survey was initially emailed on 22 June 2018, with two reminders sent to non-responders, and the survey closed six weeks later....

Notes

Conflicts of interest

None declared.

Editorial responsibility

This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.

Supplementary material

12630_2019_1311_MOESM1_ESM.pdf (109 kb)
eTABLE Survey: Perioperative management of oral glucose-lowering medications. Supplementary material 1 (PDF 109 kb)

References

  1. 1.
    Duggan EW, Carlson K, Umpierrez GE. Perioperative hyperglycemia management: an update. Anesthesiology 2017; 126: 547-60.CrossRefGoogle Scholar
  2. 2.
    Membership of the Working Party; Barker P, Creasey PE, Dhatarya K, et al. Peri-operative management of the surgical patient with diabetes 2015: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2015; 70: 1427-40.Google Scholar
  3. 3.
    Noordzij PG, Boersma E, Schreiner F, et al. Increased preoperative glucose levels are associated with perioperative mortality in patients undergoing noncardiac, nonvascular surgery. Eur J Endocrinol 2007; 156: 137-42.CrossRefGoogle Scholar
  4. 4.
    Umpierrez GE, Smiley D, Jacobs S, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care 2011; 34: 256-61.CrossRefGoogle Scholar
  5. 5.
    Peacock SC, Lovshin JA. Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in the perioperative setting. Can J Anesth 2018; 65: 143-7.CrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists' Society 2019

Authors and Affiliations

  1. 1.Department of AnesthesiaMcMaster UniversityHamiltonCanada
  2. 2.Department of AnesthesiologyUniversity of SaskatchewanSaskatoonCanada

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