Watson, and T. You are here: Diabetes. In these circumstances, it may be acceptable to proceed with surgery after explanation to the patient of the increased risks. Metformin procedure not requiring use of contrast media b. In addition, there are considerable data from patients’ feedback questionnaires concerning their experience and involvement in their own care. Critical Care ; 10 : R Patients whose diabetes is controlled on insulin should be told to halve their insulin dose on the evening before the investigation. Early involvement of the diabetes inpatient specialist team should be sought.
Type 2 diabetes is the most common form of diabetes, affecting approximately 90 per cent of people with the condition. The global incidence of diabetes is rising and the number of people affected is projected to exceed million by the year World Health Organization, The care of people with diabetes in hospitals is often inadequate Audit Commission, This is highlighted as a standard for improvement in the National Service Framework for Diabetes: Standards Department of Health, Pre and postoperative fasting and management of type 2 diabetes present problems that this article will address. However, the evidence base for this topic is limited and practice is based largely on best clinical opinion. Because of this, practice differs between trusts and it is important that readers consult local policies when caring for patients with diabetes. This sympathetic response raises hepatic glucose production. People without diabetes counteract this effect by an increase in insulin secretion. However, patients with type 2 diabetes are unable to respond in this way, which may lead to dangerous hyperglycaemia Gill, Patients who are prescribed insulin or insulin-secretion stimulating medication such as sulphonylureas may experience hypoglycaemia as a result of perioperative fasting. When these patients are anaesthetised, it is difficult to identify the usual warning signs of hypoglycaemia and this is potentially life threatening.
Surgery 2 pre diet type for diabetes
Information about duration, type of diabetes, current treatment and complications should be made available to the secondary care team. They should omit their dose on the morning of surgery. Ideally, the patient should be booked first on the operating list to minimise the period of fasting. Local anaesthetic techniques, when used as the sole anaesthetic, reduce the risk of postoperative nausea and vomiting. The Working Party recognises that these fluids may not be available in all institutions. Anaesthesia ; 63 : — The CBG should be checked before induction of anaesthesia and monitored regularly during the procedure at least hourly, or more frequently if the results are outside the target range.