Naslov
Operative treatment in patients with diabetes mellitus

Autori
Metelko, Željko ; Babić, Zdravko ; Pavlić-Renar, Ivana.

Izvornik
Neurologia Croatica (0353-8842) 49 (2000); 81-91

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, ostalo

Ključne riječi
Diabetes mellitus ; Operative treatment

Sažetak
Diabetes mellitus is the most commonly occurring endocrine disease in surgical patients. Surgical stress leads to a strong catabolic tendency with hyperglycemia and ketosis in diabetic patients. Perioperative starvation leads to potentially dangerous hypoglycemia. Diabetes itself may not be as important to perioperative outcome as its end-organ effects, although poor glycemic control may adversly affect operative outcome. Common goal of perioperative management regimens in diabetic patients is to prevent hypoglicemia and to achieve normoglycaemia or accept mild hyperglycemia that can be corrected gradually in the postoperative period. The operation should be scheduled for the morning, if possible. Non-insulin treated diabetic patients, having non-major surgery, need 2-hourly glucose observation on day of surgery only. Glucose-potassium-insulin (“GKI”) method is used in all insulin-treated patients and major surgery in non-insulin-treated patients. Two-hourly glucose and daily electrolytes measurement is recommended.“Separate line” method is advisable for emergency surgery, open-heart surgery and emergency caesarean sections, special surgery situations in diabetic patients.Patients taking oral hypoglicemic drugs and long-acting insulin can restart this therapy with first postoperative meal.

Izvorni jezik
Engleski

POVEZANOST RADA