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2012, Number 1

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Rev Cuba Endoc 2012; 23 (1)

Glycemia control in the perioperative process of patients presenting with diabetes mellitus

García GY, Licea PME, Garciga CF, Álvarez DY, Barnés DJA, Almaguer GS, Soca MJC

Language: Spanish
References: 39
Page:
PDF size: 224.18 Kb.


ABSTRACT

The diabetic patients require frequently some type of surgery or the implementation of an invasive diagnostic procedure which may even be carried out as an emergence. Nowadays the surgical risk of the diabetic patient has decrease thanks to the advances in the anesthetic techniques and to the perioperative metabolic control, although the complications are more frequent and to generate a lengthy hospitalization and a great disability rate. In the preoperative assessment it is necessary to specify exactly the diabetes's features, the type of surgical procedure, surgical anesthetic risk and to perform the fitting necessary in the habitual treatment. The continuous infusion of intravenous insulin with glucose is the more rational and physiologic method in most of surgical interventions, involving the frequent glycemia monitoring with immediate fittings. Some special situations including complicated surgeries or those of emergence, require specific therapeutical schemes, thus each staff must to have its work protocol, according the peculiarities of the surgical interventions performed. The perioperative metabolic control is essential to avoid the metabolic and acute hydroelectrolytic alterations and to favor the satisfactory course during the postoperative period. Due its significance, authors carried out a review with the current approach helping to improve the quality of care of diabetic patient requiring a surgical intervention.


REFERENCES

  1. Clement S, Braithwaite S, Magee M, Ahmann A, Smith EP, Schafer RG, et al. Management of Diabetes and Hyperglycemia in Hospitals. Diabetes Care. 2004;27:553-91.

  2. Alberti KGMM, Gill GV. The care of the diabetic patient during surgery. En: Alberti KGMM, Zimmet P, DeFronzo RA, Keen H, eds. International Textbook of Diabetes Mellitus. 2nd ed. Chichester: Wiley; 1997. p. 1243-53.

  3. Smiley DD, Umpierrez GE. Perioperative glucose control in the diabetic or nondiabetic patient. South Med J. 2006;99:580-91.

  4. Debing E, Aerden D, Van den Brande P. Diabetes Mellitus is a Predictor for Early Adverse Outcome after Carotid Endarterectomy. Vascular Endov Surg. 2011;45:28-32.

  5. Watkins PJ, Amiel SA, Howell SL, Turner E. Management of Diabetes During Surgery and other illnesses. In: Watkins PJ, Amiel SA, Howell SL, Turner E. Diabetes and its Management. 6th ed. London: Ed. Blackwell Publishing; 2003. p. 95-103.

  6. Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002;106:2067-72.

  7. Gresele P, Guglielmini G, DeAngelis M, Ciferri S, Ciofetta M, Falcinelli E, et al. Acute, short-term hyperglycemia enhances shear stress-induced platelet activation in patients with type II diabetes mellitus. J Am Coll Cardiol. 2003;41:1013-20.

  8. Pomposelli JJ, Baxter JK III, Babineau TJ, Pomfret EA, Driscoll DF, Forse RA, et al. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. J Parenteral Enteral Nutr. 1998;22:77-81.

  9. Dronge AS, Perkal MF, Kancir S. Long-term glycemic control and postoperative infectious complications. Arch Surg. 2006;141:375-80.

  10. Rassias A, Givan A, Marrin C, Whalen K, Pahl J, Yeager M. Insulin increases neutrophil count and phagocytic capacity after cardiac surgery. Anesth Analg. 2002;94:1113-9.

  11. Alserius T, Anderson RE, Hammar N, Nordqvist T, Ivert T. Elevated glycosylated haemoglobin (HbA1c) is a risk marker in coronary artery bypass surgery. Scand Card J. 2008;42:392-8.

  12. Knapik P, Cieœla D, Filipiak K, Knapik M, Zembala M. Prevalence and clinical significance of elevated preoperative glycosylated hemoglobin in diabetic patients scheduled for coronary artery surgery. Eur J Cardiothorac Surg. 2011;39:484-9.

  13. Manual de atención integral a personas con diabetes [homepage en internet] [citado 2011 junio 14] Disponible en: http://www.sld.cu/galerias/pdf/sitios/diabetes/manual de_atencion_integral_a_personas_con_diabetes.pdf

  14. Gandhi GY, Nuttall GA, Mullany CJ, Schaff HV, O'Brien PC, et al. Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial. Ann Intern Med. 2007;20:233-43.

  15. Chan R, Galas F, Hajjar L, Auler J. Intensive Perioperative Glucose Control Does Not Improve Outcomes of Patients Submitted to Open-Heart Surgery: A Randomized Controlled Trial. Clinics (Sao Paulo). 2009;64:51-60.

  16. Leibowitz G, Raizman E, Brezis M, Glaser B, Raz I, Shapira O. Effects of moderate intensity glycemic control after cardiac surgery. Ann Thorac Surg. 2010;90:1825-32.

  17. The NICE-SUGAR Study Investigators. Intensive verses conventional glucose control in critically ill patients. NEJM. 2009;360:1283-97.

  18. Moghissi ES, Korytowski MT, DiNardo M. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15:353-69.

  19. Dávila E. Evaluación preoperatoria del paciente quirúrgico. En: Dávila E, Gómez C, Álvarez M, Saínz H, Molina RM (ed.). Anestesiología Clínica. La Habana: Editorial Ciencias Médicas; 2006. p. 1-14.

  20. Santos E, Gómez Peralta F, Salvador J. Diabetes y cirugía: principios generales de tratamiento II. Rev Med Univ Navarra. 2002;46:24-37.

  21. Álvarez C, Hillman N, Castro E, Pallardo LF. Protocolo terapéutico del enfermo diabético sometido a cirugía. Medicine. 2000;8:1086-8.

  22. Cordero I. Consideraciones anestésicas en el paciente diabético con neuropatía autonómica. Rev Cubana Anest. 2010;9:24-31.

  23. Rigalleau V, Lasseur C, Perlemoine C, Barthe N, Raffaitin C, Liu C, et al. Estimation of glomerular filtration rate in diabetic subjects: Cockcroft formula or modification of Diet in Renal Disease study equation? Diabetes Care. 2005;28:838-84.

  24. Umpierrez GE, Smiley D, Jacobs S, Peng L, Temponi A, Mulligan P, 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;34:256-61.

  25. Hirsch IB. Sliding scale insulin-time to stop sliding. JAMA. 2009;301:213-4.

  26. Meneghini LF. Perioperative management of diabetes: Translating evidence into practice. Clev Clin J. 2009;76:S53-S59.

  27. Rittler P, Broedl UC, Hartl W, Göke B, Jauch K. Diabetes mellitus perioperative management. Chirurg. 2009;80:412-5.

  28. Martín I, Valero MA. Insulinoterapia. Protocolo terapéutico del paciente diabético sometido a cirugía. En: Botella JI, Valero MA, Beato P, Canovas B, Martín I, Álvarez F, et al. (eds.). Manual de Endocrinología y Nutrición. Madrid: Novo Nordisk Pharma; 2007. p. 65-7.

  29. Dagogo-Jack S, Alberti KGMM. Management of Diabetes Mellitus in Surgical Patients. Diabet Spectrum. 2002;15:45-8.

  30. Grosembacher L. Cuidados del paciente diabético en el perioperatorio. Rev Soc Arg Diabetes. 2008;42:247-50.

  31. Vann MA. Perioperative management of ambulatory surgical patients with diabetes mellitus. Curr Opin Anaesthesiol. 2009;22:718-24.

  32. Molina B, Montoya T, Olivar J, Monereo S. Guías de actuación clínica de la diabetes mellitus. Algoritmo diagnóstico y terapéutico del paciente diabético intervenido quirúrgicamente. Endocrinol Nutr. 2006;53:48-55.

  33. Marks JB. Perioperative management of diabetes. Am Fam Physician. 2003;67:93-100.

  34. 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;26:666-70.

  35. Emam IA, Allan A, Eskander K, Dhanraj K, Farag ES, El-Kadi Y, et al. Our experience of controlling diabetes in the peri-operative period of patients who underwent cardiac surgery. Diab Res Clin Pract. 2010;88:242-6.

  36. Wong J, Zoungas S, Wright C, Teede H. Evidence-based Guidelines for Perioperative Management of Diabetes in Cardiac and Vascular Surgery. World J Surg. 2010;34:500-13.

  37. Fan Y, Zhang AM, Xiao YB, Weng YG, Hetzer R. Glucose-insulin-potassium therapy in adult patients undergoing cardiac surgery: a meta-analysis. Eur J Cardiothorac Surg. 2011;40:192-9.

  38. Duncan AE, Abd-Elsayed A, Maheshwari A, Xu M, Soltesz E, Koch CG. Role of intraoperative and postoperative blood glucose concentrations in predicting outcomes after cardiac surgery. Anest. 2010;112:860-71.

  39. Hoogwerf BJ. Perioperative management of diabetes mellitus: how should we act on the limited evidence? Clev Clin J Med. 2006;73(Suppl 1):s95-s99.




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