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Glycaemic control in the perioperative period

Sebranek, J. J. ; Lugli, A. Kopp ; Coursin, D. B. ; Hemmings, H. C. ; Hemmings, H. C.

In: British Journal of Anaesthesia, 2013, vol. 111, p. i18-i34

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    Titre
    • Glycaemic control in the perioperative period
    Auteur
    • Sebranek, J. J.. Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
    • Lugli, A. Kopp. Department of Anesthesia and Intensive Care, University Hospital Basel, Basel, Switzerland
    • Coursin, D. B.. Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
    • Hemmings, H. C.. 1Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
    • Hemmings, H. C.. 1Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • British Journal of Anaesthesia, 2013, vol. 111, p. i18-i34. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:299049
    Summary
    The prevalence of type 2 diabetes mellitus and the potential for perioperative dysglycaemia (hyperglycaemia, hypoglycaemia, stress-induced hyperglycaemia, or glucose variability) continue to increase dramatically. The majority of investigations on perioperative glycaemic control focused on critically ill patients and concentrated on goals of therapy, level of intensity of insulin infusion, feeding regimes, concerns over hypoglycaemia, and promulgation of recent guidelines calling for less strict glucose control. Areas of perioperative glycaemic control that deserve further investigation include preoperative identification of patients with undiagnosed type 2 diabetes and other forms of dysglycaemia, determination of appropriate intraoperative glucose goals, and establishment of the impact and natural history of perioperative abnormalities in glucose homeostasis. In the heterogeneous adult perioperative population, it is unlikely that one standard of perioperative glycaemic control is appropriate for all patients. This review presents recent evidence and expert guidance to aid preoperative assessment, intraoperative management, and postoperative care of the dysglycaemic adult patient