Perioperative Management of Diabetes Mellitus
Diabetes Mellitus (DM) is considered as the most common multisystem endocrine-metabolic disease. there are several progressive physiological changes in the body of the person suffering from diabetes and those changes affect the body and the systems. Therefore there is a need of focus on some organs and systems during the anesthetic approach. Musculoskeletal system is highly affected as it reduces joint mobility, limits the angles of movement of the neck and which may hinder the orotracheal intubation. Some people suffer diabetic nephropathy. Autonomic gastrointestinal neuropathy Impaired neurovascular function, loss of autonomic response to hypoglycaemia, and affected thermoregulatory response to hypothermia during anesthesia are also possible. Diabetes also affects the cardiovascular system, patients suffereing from diabetes Mellitus also have high intraoperative cardiovascular instability.
Patients suffering from diabetes undergoing surgery, should be evaluated and observed prior to anesthesia. When unidentified as diabetic, surgical patients should be screened for all possible risk factors for undiagnosed DM, such as obesity, metabolic syndrome, diabetogenic drugs, personal history of gestational DM or transient hyperglycemia, family history of DM and suggestive symptoms. With proper guidance, diabetics should be allowed to maintain control and continue self-administration of their medication. In emergency surgeries, by definition, there is no opportunity for a plan to be performed, and modification of the patient's normal medication is only possible if the patient is physiologically well and the procedure is scheduled, as in minor trauma surgery. In ambulatory surgery, OADs can be continued if the patient is controlled.
Kindly follow the given link containing article published online in Journal of Anesthesia & Clinical Research. https://www.omicsonline.org/open-access/perioperative-management-of-diabetes-mellitus-a-review-108963.html
John George Ph.D.
J Anesth Clin Res