Nadine E Palermo1, Rajesh Garg2. 1. Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Suite 381, Boston, MA, 02115, USA. 2. Comprehensive Diabetes Center, Miller School of Medicine, University of Miami, 5555 Ponce de Leon Blvd, Coral Gables, FL, 33145, USA. rgarg@miami.edu.
Abstract
PURPOSE OF REVIEW: Several studies have demonstrated the benefits of glycemic control in the perioperative period and there is ongoing interest in development of systematic approaches to achieving glycemic control. This review discusses currently available data and proposes a new approach to the management of hyperglycemia in the perioperative period. RECENT FINDINGS: In a recent study, we demonstrated that early preoperative identification of patients with poorly controlled diabetes and proactive treatment through various phases of surgery improves glycemic control, lowers the risk of surgical complications, and decreases the length of hospital stay. Implementation of a perioperative diabetes program that systematically identifies and treats patients with poor glycemic control early in the preoperative period is feasible and improves clinical care of patients undergoing elective surgery.
PURPOSE OF REVIEW: Several studies have demonstrated the benefits of glycemic control in the perioperative period and there is ongoing interest in development of systematic approaches to achieving glycemic control. This review discusses currently available data and proposes a new approach to the management of hyperglycemia in the perioperative period. RECENT FINDINGS: In a recent study, we demonstrated that early preoperative identification of patients with poorly controlled diabetes and proactive treatment through various phases of surgery improves glycemic control, lowers the risk of surgical complications, and decreases the length of hospital stay. Implementation of a perioperative diabetes program that systematically identifies and treats patients with poor glycemic control early in the preoperative period is feasible and improves clinical care of patients undergoing elective surgery.
Entities:
Keywords:
Diabetes mellitus; Hyperglycemia; Perioperative treatment; Stress hyperglycemia; Surgery outcomes
Authors: Gunjan Y Gandhi; Gregory A Nuttall; Martin D Abel; Charles J Mullany; Hartzell V Schaff; Peter C O'Brien; Matthew G Johnson; Arthur R Williams; Susanne M Cutshall; Lisa M Mundy; Robert A Rizza; M Molly McMahon Journal: Ann Intern Med Date: 2007-02-20 Impact factor: 25.391
Authors: Harold L Lazar; Stuart R Chipkin; Carmel A Fitzgerald; Yusheng Bao; Howard Cabral; Carl S Apstein Journal: Circulation Date: 2004-03-08 Impact factor: 29.690
Authors: Margarita Ramos; Zain Khalpey; Stuart Lipsitz; Jill Steinberg; Maria Theresa Panizales; Michael Zinner; Selwyn O Rogers Journal: Ann Surg Date: 2008-10 Impact factor: 12.969