special subjects
Perioperative Management
Diabetes
On the day of surgery, patients withinsulin-dependent diabetes are typically given one third of their usualinsulindose in the morning. Patients who take oral drugs are given half of their usual dose. If possible, surgery is done early in the day. The anesthesiologist monitors glucose levels during surgery and gives additionalinsulinordextroseas needed. Close monitoring with fingerstick testing continues throughout the perioperative period. In the immediate postoperative period,insulinis given on a sliding scale. The usual at-homeinsulinregimen is not restarted until patients resume their regular diet. Oral hypoglycemic drugs are usually restarted when the patient is discharged from the hospital. 