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PERIOPERATIVE CONTROL OF BLOOD GLUCOSE

Year 2015, Volume: 2 Issue: 3, 203 - 207, 25.02.2015
https://doi.org/10.17546/msd.33131

Abstract

This review mainly focuses on the management of type 2 diabetes in the preoperative setting with a special emphasis on intraoperative glycemic control. Some patients learn their diagnosis of diabetes just prior to the surgery. The prevalence of previously undiagnosed diabetes is reported to be 5,2-10% in literature. Treatment protocols must be tailored individually but evidence based approach in insulin administration and close monitoring of blood glucose are important in order to avoid both hyper and hypoglycemia.

References

  • http:// euro.who.int/en/what-we-do/health-topics/noncommunicablediseases/ diabetes/data-and-statistics
  • Girard M, Schricker T. Perioperative glucose control: living in uncertain times--Continuing Professional Development. Can J Anaesth. 2011 Mar;58(3):312-20,320-9
  • Bochicchio GV, Sung J, Joshi M, et al. Persistent hyperglycemia is predictive of outcome in critically ill trauma patients. J Trauma 2005; 58: 921–4 51
  • Bochicchio GV, Salzano L, Joshi M, Bochicchio K, Scalea TM. Admission preoperative glucose is predictive of morbidity and mortality in trauma patients who require immediate operative intervention. Am Surg 2005; 71: 171–4
  • Kerby JD, Griffin RL, MacLennan P, Rue LW. Stress-induced hyperglycemia, not diabetic hyperglycemia, is associated with higher mortality in trauma. Ann Surg 2012; 256: 446–52
  • Dhatariya K, Levy N, Kilvert A, et al. NHS diabetes guideline for the perioperative management of the adult patient with diabetes. Diabet Med 2012; 29: 420–33
  • Carson JL, Scholz PM, Chen AY, Peterson ED, Gold J, Schneider SH. Diabetes mellitus increases short-term mortality and morbidity in patients undergoing coronary artery bypass graft surgery. J Am Coll Cardiol 2002; 40: 418–23
  • Szabo Z, Hakanson E, Svedjeholm R. Early postoperative outcome and medium-term survival in 540 diabetic and 2239 nondiabetic patients undergoing coronary artery bypass grafting. Ann Thorac Surg 2002; 74: 712–9
  • Schuster JM, Rechtine G, Norvell DC, Dettori JR. The influence of perioperative risk factors and therapeutic interventions on infection rates after spine surgery: a systematic review. Spine (Phila Pa 1976). 2010 Apr 20;35(9 Suppl):S125-37
  • GodoyDA, Di Napoli M, Biestro A, Lenhardt R. Perioperative glucose control in neurosurgical patients. Anesthesiol Res Pract 2012; 2012: 690362
  • Milaskiewicz RM, Hall GM. Diabetes and anaesthesia: the past decade. Br J Anaesth 1992; 68: 198–206
  • http://circ.ahajournals.org/content/early/2014/07/31/CIR.0000000000000105.citation
  • American Diabetes Association. Standards of medical care in diabetes— 2013. Diabetes Care 2013; 36 (Suppl. 1): S11–66
  • Abdelmalak B,AbdelmalakJB, Knittel J, et al.Theprevalenceof undiagnosed diabetes in non-cardiac surgery patients, an observational study. Can J Anaesth 2010; 57: 1058–64
  • Lauruschkat AH, Arnrich B, Albert AA, et al. Prevalence and risks of undiagnosed diabetes mellitus in patients undergoing coronary artery bypass grafting. Circulation 2005; 112: 2397–402
  • Kohl BA, Schwartz S. How to manage perioperative endocrine insufficiency. Anesthesiol Clin 2010; 28: 139–55
  • Sato H, Carvalho G, Sato T, Lattermann R,MatsukawaT, Schricker T. The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery. J Clin Endocrinol Metab 2010; 95: 4338–44
  • Han HS, Kang SB. Relations between long-term glycemic control and postoperative wound and infectious complications after total knee arthroplasty in type 2 diabetics. Clin Orthoped Surg 2013; 5: 118–23
  • Dhatariya K, Levy N, Kilvert A, Watson B, Cousins D, Flanagan D, Hilton L, Jairam C, Leyden K, Lipp A, Lobo D, Sinclair-Hammersley M, Rayman G; Joint British Diabetes Societies. NHS Diabetes guideline for the perioperative management of the adult patient with diabetes. Diabet Med. 2012 Apr;29(4):420-33
  • Dell’aquila A, Ellger B. perioperative glycemic control ;what is worth the effort. Curr Opin Anesthesiol 2013, 26:438–443
  • Duncan AE.Hyperglycemia and perioperative glucose management Curr Pharm Des. 2012 ; 18(38): 6195–6203
  • Gu W, Pagel PS, Warltier DC, Kersten JR. Modifying cardiovascular risk in diabetes mellitus. Anesthesiology. 2003; 98:774–9.
  • Bailey CJ, Turner RC. Drug therapy: Metformin. N Engl J Med. 1996; 334(9):574–9.
  • Duncan AE. Hyperglycemia and perioperative glucose management. Curr Pharm Des. 2012;18(38):6195-203
  • Houlden R, Capes S, Clement M, Miller D. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. In-hospital management of diabetes. Can J Diabetes. 2013 Apr;37 Suppl 1:S77-81.
  • Umpierrez GE, Smiley D, Jacobs S, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care 2011;34:256
  • Umpierrez G, Maynard G. Glycemic chaos (not glycemic control) still the rule for inpatient care: how do we stop the insanity? J Hosp Med 2006;1:141.
  • Umpierrez GE, Palacio A, Smiley D. Sliding scale insulin use: myth or insanity? Am J Med 2007;120:563
  • Thomas DJ, Platt HS, Alberti KG. Insulin-dependent diabetes during the peri-operative period. An assessment of continuous glucose– insulin–potassium infusion, and traditional treatment. Anaesthesia 1984; 39: 629–637
  • Trence DL, Kelly JL, Hirsch IB. The rationale and management of hyperglycemia for in-patients with cardiovascular disease: time for change. J Clin Endocrinol Metab. 2003 Jun;88(6):2430-7
  • Markovitz LJ, Wiechmann RJ, Harris N, Hayden V, Cooper J, Johnson G, Harelstad R, Calkins L, Braithwaite SS. Description and evaluation of a glycemic management protocol for patients with diabetes undergoing heart surgery. Endocr Pract. 2002 Jan-Feb;8(1):10-8
  • Emam IA, Allan A, Eskander K, Dhanraj K, Farag el-S, El-Kadi Y, Khalaf W, Riad SR, Somia R. Our experience of controlling diabetes in the peri-operative period of patients who underwent cardiac surgery. Diabetes Res Clin Pract. 2010 Jun;88(3):242-6
  • Gandhi GY, Nuttall GA, Abel MD, et al. Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients. Mayo Clin Proc 2005; 80: 862–6
  • Doenst T,Wijeysundera D, Karkouti K, et al. Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery. J Thorac Cardiovasc Surg 2005; 130: 1144
  • Ouattara A, Lecomte P, Le Manach Y, Landi M, Jacqueminet S, Platonov I, Bonnet N, Riou B, Coriat P. Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients. Anesthesiology. 2005 Oct;103(4):687-94
  • Kohl BA, Hammond MS, Ochroch EA. Implementation of an intraoperative glycemic control protocol for cardiac surgery in a high-acuity academic medical center: an observational study. J Clin Anesth. 2013 Mar;25(2):121-8
  • Kang H, Ahn KJ, Choi JY, Park HJ, Park SJ, Lee SK. Efficacy of insulin glargine in perioperative glucose control in type 2 diabetic patients. Eur J Anaesthesiol. 2009 Aug;26(8):666-70.
  • Subramaniam B, Panzica PJ, Novack V, et al. Continuous perioperative insülin infusion decreases major cardiovascular events in patients undergoing vascular surgery: a prospective, randomized trial. Anesthesiology 2009; 110:970–977
  • Gandhi GY, Nuttall GA, Abel MD, Mullany CJ, Schaff HV, O'Brien PC, Johnson MG,Williams AR, Cutshall SM, Mundy LM, Rizza RA, McMahon MM. Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial. Ann Intern Med. 2007 Feb 20;146(4):233-43
  • Furnary AP, Zerr KJ, Grunkemeier GL, Starr A. Continuous intravenous insülin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg. 1999 Feb;67(2):352-60
  • van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M,et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001; 345:1359-67
  • Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, Van Wijngaerden E, Bobbaers H, Bouillon R. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006 Feb 2;354(5):449-61
  • Hua J, Chen G, Li H, et al. Intensive intraoperative insulin therapy versus conventional insulin therapy during cardiac surgery: a meta-analysis. J Cardiothorac Vasc Anesth 2012; 26: 829–34
  • Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery; European Society of Cardiology (ESC), Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, Gorenek B, Hennerici MG, Iung B, Kelm M, Kjeldsen KP, Kristensen SD, Lopez-Sendon J, Pelosi P, Philippe F, Pierard L, Ponikowski P, Schmid JP, Sellevold OF, Sicari R, Van den Berghe G, Vermassen F. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J. 2009 Nov;30(22):2769-812
  • Qaseem A, Humphrey LL, Chou R, Snow V, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Use of intensive insulin therapy for the management of glycemic control in hospitalized patients: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2011 Feb 15;154(4):260-7
  • Schmeltz LR, DeSantis AJ, Schmidt K, et al. Conversion of intravenous insülin infusions to subcutaneously administered insulin glargine in patients with hyperglycemia. Endocr Pract 2006;12:641e50
  • Masharani U, German MS. Pancreatic Hormones and diabetes mellitus. In:Gardner DG, Shoback D,ed. Greenspans Basciand Clinical Endocrinology 9th ed.McGraw Hill 2011:573-655
  • Abdelmalak BB, Lansang MC. Revisiting tight glycemic control in perioperative and critically ill patients: when one size may not fit all. J Clin Anesth. 2013 Sep;25(6):499-507

Perioperative control of blood glucose

Year 2015, Volume: 2 Issue: 3, 203 - 207, 25.02.2015
https://doi.org/10.17546/msd.33131

Abstract

References

  • http:// euro.who.int/en/what-we-do/health-topics/noncommunicablediseases/ diabetes/data-and-statistics
  • Girard M, Schricker T. Perioperative glucose control: living in uncertain times--Continuing Professional Development. Can J Anaesth. 2011 Mar;58(3):312-20,320-9
  • Bochicchio GV, Sung J, Joshi M, et al. Persistent hyperglycemia is predictive of outcome in critically ill trauma patients. J Trauma 2005; 58: 921–4 51
  • Bochicchio GV, Salzano L, Joshi M, Bochicchio K, Scalea TM. Admission preoperative glucose is predictive of morbidity and mortality in trauma patients who require immediate operative intervention. Am Surg 2005; 71: 171–4
  • Kerby JD, Griffin RL, MacLennan P, Rue LW. Stress-induced hyperglycemia, not diabetic hyperglycemia, is associated with higher mortality in trauma. Ann Surg 2012; 256: 446–52
  • Dhatariya K, Levy N, Kilvert A, et al. NHS diabetes guideline for the perioperative management of the adult patient with diabetes. Diabet Med 2012; 29: 420–33
  • Carson JL, Scholz PM, Chen AY, Peterson ED, Gold J, Schneider SH. Diabetes mellitus increases short-term mortality and morbidity in patients undergoing coronary artery bypass graft surgery. J Am Coll Cardiol 2002; 40: 418–23
  • Szabo Z, Hakanson E, Svedjeholm R. Early postoperative outcome and medium-term survival in 540 diabetic and 2239 nondiabetic patients undergoing coronary artery bypass grafting. Ann Thorac Surg 2002; 74: 712–9
  • Schuster JM, Rechtine G, Norvell DC, Dettori JR. The influence of perioperative risk factors and therapeutic interventions on infection rates after spine surgery: a systematic review. Spine (Phila Pa 1976). 2010 Apr 20;35(9 Suppl):S125-37
  • GodoyDA, Di Napoli M, Biestro A, Lenhardt R. Perioperative glucose control in neurosurgical patients. Anesthesiol Res Pract 2012; 2012: 690362
  • Milaskiewicz RM, Hall GM. Diabetes and anaesthesia: the past decade. Br J Anaesth 1992; 68: 198–206
  • http://circ.ahajournals.org/content/early/2014/07/31/CIR.0000000000000105.citation
  • American Diabetes Association. Standards of medical care in diabetes— 2013. Diabetes Care 2013; 36 (Suppl. 1): S11–66
  • Abdelmalak B,AbdelmalakJB, Knittel J, et al.Theprevalenceof undiagnosed diabetes in non-cardiac surgery patients, an observational study. Can J Anaesth 2010; 57: 1058–64
  • Lauruschkat AH, Arnrich B, Albert AA, et al. Prevalence and risks of undiagnosed diabetes mellitus in patients undergoing coronary artery bypass grafting. Circulation 2005; 112: 2397–402
  • Kohl BA, Schwartz S. How to manage perioperative endocrine insufficiency. Anesthesiol Clin 2010; 28: 139–55
  • Sato H, Carvalho G, Sato T, Lattermann R,MatsukawaT, Schricker T. The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery. J Clin Endocrinol Metab 2010; 95: 4338–44
  • Han HS, Kang SB. Relations between long-term glycemic control and postoperative wound and infectious complications after total knee arthroplasty in type 2 diabetics. Clin Orthoped Surg 2013; 5: 118–23
  • Dhatariya K, Levy N, Kilvert A, Watson B, Cousins D, Flanagan D, Hilton L, Jairam C, Leyden K, Lipp A, Lobo D, Sinclair-Hammersley M, Rayman G; Joint British Diabetes Societies. NHS Diabetes guideline for the perioperative management of the adult patient with diabetes. Diabet Med. 2012 Apr;29(4):420-33
  • Dell’aquila A, Ellger B. perioperative glycemic control ;what is worth the effort. Curr Opin Anesthesiol 2013, 26:438–443
  • Duncan AE.Hyperglycemia and perioperative glucose management Curr Pharm Des. 2012 ; 18(38): 6195–6203
  • Gu W, Pagel PS, Warltier DC, Kersten JR. Modifying cardiovascular risk in diabetes mellitus. Anesthesiology. 2003; 98:774–9.
  • Bailey CJ, Turner RC. Drug therapy: Metformin. N Engl J Med. 1996; 334(9):574–9.
  • Duncan AE. Hyperglycemia and perioperative glucose management. Curr Pharm Des. 2012;18(38):6195-203
  • Houlden R, Capes S, Clement M, Miller D. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. In-hospital management of diabetes. Can J Diabetes. 2013 Apr;37 Suppl 1:S77-81.
  • Umpierrez GE, Smiley D, Jacobs S, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care 2011;34:256
  • Umpierrez G, Maynard G. Glycemic chaos (not glycemic control) still the rule for inpatient care: how do we stop the insanity? J Hosp Med 2006;1:141.
  • Umpierrez GE, Palacio A, Smiley D. Sliding scale insulin use: myth or insanity? Am J Med 2007;120:563
  • Thomas DJ, Platt HS, Alberti KG. Insulin-dependent diabetes during the peri-operative period. An assessment of continuous glucose– insulin–potassium infusion, and traditional treatment. Anaesthesia 1984; 39: 629–637
  • Trence DL, Kelly JL, Hirsch IB. The rationale and management of hyperglycemia for in-patients with cardiovascular disease: time for change. J Clin Endocrinol Metab. 2003 Jun;88(6):2430-7
  • Markovitz LJ, Wiechmann RJ, Harris N, Hayden V, Cooper J, Johnson G, Harelstad R, Calkins L, Braithwaite SS. Description and evaluation of a glycemic management protocol for patients with diabetes undergoing heart surgery. Endocr Pract. 2002 Jan-Feb;8(1):10-8
  • Emam IA, Allan A, Eskander K, Dhanraj K, Farag el-S, El-Kadi Y, Khalaf W, Riad SR, Somia R. Our experience of controlling diabetes in the peri-operative period of patients who underwent cardiac surgery. Diabetes Res Clin Pract. 2010 Jun;88(3):242-6
  • Gandhi GY, Nuttall GA, Abel MD, et al. Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients. Mayo Clin Proc 2005; 80: 862–6
  • Doenst T,Wijeysundera D, Karkouti K, et al. Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery. J Thorac Cardiovasc Surg 2005; 130: 1144
  • Ouattara A, Lecomte P, Le Manach Y, Landi M, Jacqueminet S, Platonov I, Bonnet N, Riou B, Coriat P. Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients. Anesthesiology. 2005 Oct;103(4):687-94
  • Kohl BA, Hammond MS, Ochroch EA. Implementation of an intraoperative glycemic control protocol for cardiac surgery in a high-acuity academic medical center: an observational study. J Clin Anesth. 2013 Mar;25(2):121-8
  • Kang H, Ahn KJ, Choi JY, Park HJ, Park SJ, Lee SK. Efficacy of insulin glargine in perioperative glucose control in type 2 diabetic patients. Eur J Anaesthesiol. 2009 Aug;26(8):666-70.
  • Subramaniam B, Panzica PJ, Novack V, et al. Continuous perioperative insülin infusion decreases major cardiovascular events in patients undergoing vascular surgery: a prospective, randomized trial. Anesthesiology 2009; 110:970–977
  • Gandhi GY, Nuttall GA, Abel MD, Mullany CJ, Schaff HV, O'Brien PC, Johnson MG,Williams AR, Cutshall SM, Mundy LM, Rizza RA, McMahon MM. Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial. Ann Intern Med. 2007 Feb 20;146(4):233-43
  • Furnary AP, Zerr KJ, Grunkemeier GL, Starr A. Continuous intravenous insülin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg. 1999 Feb;67(2):352-60
  • van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M,et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001; 345:1359-67
  • Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, Van Wijngaerden E, Bobbaers H, Bouillon R. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006 Feb 2;354(5):449-61
  • Hua J, Chen G, Li H, et al. Intensive intraoperative insulin therapy versus conventional insulin therapy during cardiac surgery: a meta-analysis. J Cardiothorac Vasc Anesth 2012; 26: 829–34
  • Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery; European Society of Cardiology (ESC), Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, Gorenek B, Hennerici MG, Iung B, Kelm M, Kjeldsen KP, Kristensen SD, Lopez-Sendon J, Pelosi P, Philippe F, Pierard L, Ponikowski P, Schmid JP, Sellevold OF, Sicari R, Van den Berghe G, Vermassen F. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J. 2009 Nov;30(22):2769-812
  • Qaseem A, Humphrey LL, Chou R, Snow V, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Use of intensive insulin therapy for the management of glycemic control in hospitalized patients: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2011 Feb 15;154(4):260-7
  • Schmeltz LR, DeSantis AJ, Schmidt K, et al. Conversion of intravenous insülin infusions to subcutaneously administered insulin glargine in patients with hyperglycemia. Endocr Pract 2006;12:641e50
  • Masharani U, German MS. Pancreatic Hormones and diabetes mellitus. In:Gardner DG, Shoback D,ed. Greenspans Basciand Clinical Endocrinology 9th ed.McGraw Hill 2011:573-655
  • Abdelmalak BB, Lansang MC. Revisiting tight glycemic control in perioperative and critically ill patients: when one size may not fit all. J Clin Anesth. 2013 Sep;25(6):499-507
There are 48 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Review Article
Authors

Serife Kuşkonmaz

Mustafa Arslan

Publication Date February 25, 2015
Published in Issue Year 2015 Volume: 2 Issue: 3

Cite

APA Kuşkonmaz, S., & Arslan, M. (2015). PERIOPERATIVE CONTROL OF BLOOD GLUCOSE. Medical Science and Discovery, 2(3), 203-207. https://doi.org/10.17546/msd.33131
AMA Kuşkonmaz S, Arslan M. PERIOPERATIVE CONTROL OF BLOOD GLUCOSE. Med Sci Discov. April 2015;2(3):203-207. doi:10.17546/msd.33131
Chicago Kuşkonmaz, Serife, and Mustafa Arslan. “PERIOPERATIVE CONTROL OF BLOOD GLUCOSE”. Medical Science and Discovery 2, no. 3 (April 2015): 203-7. https://doi.org/10.17546/msd.33131.
EndNote Kuşkonmaz S, Arslan M (April 1, 2015) PERIOPERATIVE CONTROL OF BLOOD GLUCOSE. Medical Science and Discovery 2 3 203–207.
IEEE S. Kuşkonmaz and M. Arslan, “PERIOPERATIVE CONTROL OF BLOOD GLUCOSE”, Med Sci Discov, vol. 2, no. 3, pp. 203–207, 2015, doi: 10.17546/msd.33131.
ISNAD Kuşkonmaz, Serife - Arslan, Mustafa. “PERIOPERATIVE CONTROL OF BLOOD GLUCOSE”. Medical Science and Discovery 2/3 (April 2015), 203-207. https://doi.org/10.17546/msd.33131.
JAMA Kuşkonmaz S, Arslan M. PERIOPERATIVE CONTROL OF BLOOD GLUCOSE. Med Sci Discov. 2015;2:203–207.
MLA Kuşkonmaz, Serife and Mustafa Arslan. “PERIOPERATIVE CONTROL OF BLOOD GLUCOSE”. Medical Science and Discovery, vol. 2, no. 3, 2015, pp. 203-7, doi:10.17546/msd.33131.
Vancouver Kuşkonmaz S, Arslan M. PERIOPERATIVE CONTROL OF BLOOD GLUCOSE. Med Sci Discov. 2015;2(3):203-7.