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Special Surgical Situations in Diabetes: Part 2

  • Sanjeev Kelkar
  • Shubhangi Muley
  • Prakash Ambardekar
Chapter

Abstract

Most frequently such a patient would usually be advanced in years, often with diabetes of long duration and likely to have obvious or ongoing complication of diabetes. There is poor tolerance of hypoglycemia in the elderly. The discussion that follows is relevant not only to the urological surgical patient but to all elderly patients in general. These points were not explained in greater detail earlier. The elderly Indian is not an active individual. Barring some morning walk which is on the increase in Indian cities despite the traffic congested and somewhat hazardous roads, they are sedentary individuals. Hence, exercise intolerance (either angina or dyspnea) may be difficult to assess clinically. It may not always be possible to put them to treadmill to detect exercise-induced angina. A relatively noninvasive procedure like 64-slice CT to detect coronary calcification degree is advisable if the patient is diagnosed to have symptoms of coronary artery disease.

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Additional Reading

  1. Busetto L. Practical recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management. Obes Facts. 2017;10:597–632.  https://doi.org/10.1159/000481825.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Dixon JB, Zimmet P, Alberti KG, Rubino F, on Behalf of the International Diabetes Federation Taskforce on Epidemiology and Prevention. Bariatric surgery: an IDF statement for obese type 2 diabetes. Diabet Med. 2011;28:628–42.  https://doi.org/10.1111/j.1464-5491.2011.03306.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Sanjeev Kelkar
    • 1
  • Shubhangi Muley
    • 2
  • Prakash Ambardekar
    • 3
  1. 1.Private PracticePuneIndia
  2. 2.Senior Consultant AnesthesiologistCentral India Institute of Medical ScienceNagpurIndia
  3. 3.Consultant, AnesthesioligistFortis S L Raheja HospitalMumbaiIndia

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