- In these society-driven consensus guidelines, an expert task force under the provision of the Society of Ambulatory Anesthesia was convened to review the evidence and update guidelines for the perioperative management of adult patients with diabetes in the ambulatory setting
- Readers are encouraged to review the extensive recommendations. The following are some of the recommendations rated as strong:
- Liberal intraoperative blood glucose concentration targets of 180-250 mg/dl are recommended based on patient and procedure characteristics.
- In the absence of diabetic ketoacidosis (DKA) or Hyperglycemic hyperosmolar non-ketotic syndrome (HHNS), cases do not need to be canceled for hyperglycemia.
- Water should be used in lieu of preoperative carbohydrate loading in diabetic patients
- Hemoglobin A1C levels should not be used to determine whether a case should be postponed
- The use of subcutaneous insulin administration for management of hyperglycemia is recommended
- Low-dose dexamethasone (4mg) can be used for most diabetic patients if indicated.
- Point-of-care glucose monitoring should be used to confirm accuracy of continuous glucose monitors and automated insulin dosing systems
Summary of "Society for Ambulatory Anesthesia Updated Consensus Statement on Perioperative Blood Glucose Management in Adult Patients With Diabetes Mellitus Undergoing Ambulatory Surgery"
Summary published September 30, 2024