Der Diabetologe

, Volume 13, Issue 4, pp 277–290 | Cite as

Perioperatives Management von Menschen mit Diabetes bei elektiven Eingriffen

Teil 2
  • R. Landgraf
  • V. Klauss
  • M. Middeke
  • F. Tretter
  • J. Koscielny
CME

Zusammenfassung

Größere diagnostische und therapeutische Eingriffe sind für Menschen mit Diabetes besonders problematisch und gefährlich. Stoffwechselentgleisungen, kardiovaskuläre, renale, neurologische, psychiatrische und thrombembolische Komplikationen sind nicht selten. Wesentliche Gründe für deren überdurchschnittliche Rate bei Diabetespatienten im Krankenhaus sind deren häufige Multimorbidität, die notwendige Polypharmazie, eine kurze Liegedauer, unzureichendes Training von Ärzten und Pflegepersonal dieser komplex Kranken, Kostendruck und ungenügende Vorbereitung der Patienten vor elektiven Eingriffen. Die perioperative Betreuung von Erwachsenen mit deren Diabeteserkrankung wurde im Teil 1 dieses Beitrags in den einzelnen Phasen von präoperativ bis zur Entlassung diskutiert (Der Diabetologe 2017. DOI:  10.1007/s11428-017-0202-1), im Teil 2 werden detaillierte Empfehlungen zum Umgang mit Psychopharmaka, Kardiaka, Antihypertensiva und Antikoagulanzien prä- und perioperativ gegeben.

Schlüsselwörter

Metabolische Kontrolle Psychopharmaka Kardiaka Antihypertensiva  Antikoagulanzien 

Perioperative management of diabetic patients undergoing elective procedures

Part 2

Abstract

Major diagnostic and therapeutic procedures are particularly problematic and hazardous in individuals with diabetes. Metabolic imbalances, as well as cardiovascular, renal, neurological, psychiatric and thromboembolic complications are not uncommon. The main causes of the above-averagely high rate of peri- and postoperative complications in diabetic inpatients undergoing elective procedures include: multimorbidity, polypharmacy, short hospital stay, inadequate training of physicians and nurses dealing with this complex disease, cost pressure, and insufficient patient preparation. Part 1 discusses the perioperative management of the diabetes in adults during the individual stages, ranging from the preoperative phase to discharge (Der Diabetologe 2017. DOI:  10.1007/s11428-017-0202-1), while Part 2 provides detailed recommendations on the pre- and perioperative management of psychotropic drugs, cardiovascular agents, antihypertensive drugs, and anticoagulants.

Keywords

Metabolic control Psychotropic drugs Cardiovascular agents Antihypertensiv agents  Anticoagulants  

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

R. Landgraf, V. Klauss, M. Middeke, F. Tretter und J. Koscielny geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • R. Landgraf
    • 1
  • V. Klauss
    • 2
  • M. Middeke
    • 3
  • F. Tretter
    • 4
  • J. Koscielny
    • 5
  1. 1.Deutsche Diabetes StiftungMünchenDeutschland
  2. 2.Gemeinschaftspraxis Kardiologie Innenstadt MünchenMünchenDeutschland
  3. 3.Hypertoniezentrum München HZM®MünchenDeutschland
  4. 4.Bayerische Akademie für Suchtfragen in Forschung und Praxis BAS e. V.MünchenDeutschland
  5. 5.Gerinnungsambulanz, Institut für TransfusionsmedizinCharité – Universitätsmedizin BerlinBerlinDeutschland

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