Abstract
Surgical stress can be associated with exacerbation of hyperglycemia in patients with T2DM and “stress hyperglycemia” in non diabetic patients. Among hospitalised patients, adverse outcomes are more frequent in patients with hyperglycemia compared to those with normal glucose levels. Inadequate management of T2DM may therefore have an important negative role in determining safety, early outcomes, and cost of surgical procedures in morbidly obese patients. The issue of 2TDM management in bariatric patients was specifically addressed in authoritative guidelines for clinical practice and will be briefly reviewed in this chapter, moving through the preoperative, perioperative and early postoperative phases of the bariatric procedure. Patients with T2DM require attention and special care during all the phases. The core of T2DM management during the more critical perioperative phase should be a judicious balance between the prevention of overt hyperglycemia and the avoidance of severe hypoglycaemia. Management of T2DM during the different phases requires a multidisciplinary team approach.
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Busetto, L. (2013). How and When Should Diabetes in the Obese Patient be Treated?. In: Leykin, Y., Brodsky, J. (eds) Controversies in the Anesthetic Management of the Obese Surgical Patient. Springer, Milano. https://doi.org/10.1007/978-88-470-2634-6_7
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DOI: https://doi.org/10.1007/978-88-470-2634-6_7
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