anesthesia in diabetes type 1 pdf - PDF Anesthetic considerations in diabetic patients criteria diagnosis of diabetes mellitus Part I preoperative Anesthesia for patients with diabetes mellitus and or UpToDate Minor surgery type 2 diabetes ON insulintype 1 diabetes 1st on list Take normal medication on day prior Omit morning SC insulin if glucose 7 mmoll Give half normal insulin if glucose 7 mmoll Monitor blood glucose 1 hour preop intraoperatively at least once 2 hourly until eating and then 4 hourly If on insulin at home divide 24 hr dose by 24 give 12 to 23 that per hour as an IV insulin infusion Consider bolusing a few units up front Preoperatively see SAMBA guidelines below Type II diabetes diet controlled fast check blood glucose Type II diabetes on oral hypoglycemics fast hold pills morning of surgery check blood glucose Tight metabolic control is important for both type 1 and type 2 patients If control has been tight in the preceding weeks then fluid and electrolyte balance will be essentially normal The best marker for recent control is the percentage of glycosylated haemoglobin HbA 1C If available levels less than 7 indicate good control whilst levels Anesthesia Considerations for Diabetes Mellitus Type 1 diabetes always requires the administration of insulin and type 2 patients undergoing moderate or major surgery will require conversion to an insulin regimen during the perioperative period Keywords anesthesia diabetes mellitus glycemic control surgery 1 Introduction Patients with diabetes have a higher incidence of morbidity In the USA 3040 of patients with type 1 diabetes will develop diabetic nephropathy and endstage renal failure 93 There is now substantial evidence that angiotensinconverting enzyme ACE inhibitors have a renal protective effect in patients with type 1 diabetes 61 This may also be the case in type 2 diabetes but the evidence is penyakit diabetes melitus disebabkan karena kekurangan hormon less Anaesthetic management of patients with diabetes mellitus Table 1 Classification of diabetes mellitus Insulin Dependent Type I Non Insulin Dependent Type II Age of onset Infancy to twenties Sixties onwards occasionally younger Pathology Pancreas unable to produce Body unable to use insulin properly insulin autoimmune disorder Treatment Insulin Diet and oral hypoglycaemics Note Perianesthesia Diabetic Management Strategies PeriAnesthesia Diabetic Management Strategies 8 Pointofcare POC capillary blood glucose BG meters are commonly used in hospitals Testing should take place in preoperative holding area and then every 1 to 2 hours during the perioperative period Type 1 diabetes is a demanding condition and requires ongoing professional medical educational and psychosocial support Care may differ at particular times of life such as at the point of diagnosis during concomitant illness or pregnancy and later in life PDF PERIANESTHESIA DIABETIC MANAGEMENT STRATEGIES Harvard University Anaesthesia and Diabetes Mellitus Virtual Library WFSA Resource Library Diabetes is the most common endocrine disease affecting 1 in 10 adults and found to be the seventh leading cause of death in the United States in 2015 When patients with diabetes require anesthesia associated comorbidities such as cardiovascular disease obesity hypertension neuropathy and nephropathy can complicate perioperative care The Management of Type 1 Diabetes in Adults A Consensus Report by the PDF Anaesthesia and Diabetes Mellitus WFSA Resource Library During the past 2030 years the prevalence of diabetes mellitus DM has rapidly increased throughout the world the prediction being that it will increase by 200 in the next several decades 14 Inevitably physicians will be confronted with an increasing population of diabetic patients undergoing anesthesia and surgery who may have PDF Anesthetic Management of Patient with Diabetes Mellitus IJSR PDF Clinical Management of Diabetes Mellitus diabetes dan sistem neurotropik During Anaesthesia and Surgery
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