Surgery is a part and parcel of most medical conditions; and diabetes is no exception to that. Diabetic patients undergo surgery at very high rate, as per reports.
Before surgery, the patient is kept in fasting state. Patient is in stress condition at this time. This stress disturbs homeostasis; further resulting in diabetic crisis. 42% mortality has been observed due to the same.
Therefore, careful attention should be paid to the metabolic status of people with diabetes undergoing surgical procedures.
Such people should be admitted to the hospital 1-2 days prior to surgery. Surgery should be performed after ensuring glycemic control. In other words, until and unless diabetic homeostasis is achieved, surgery should not be performed; although treatment varies from person to person.
Major types of stresses related with diabetes are metabolic stress response. In this catabolic hormones are released in a greater amount. Inhibition of insulin and secretin is observed. Pancreatic beta-cell function is impaired totally during surgery.
Five types of patient groups were studied under separate headings:
Patients treated with diet alone
Patients treated with oral antidiabetic drug
Insulin treated surgery-minor surgeries
Insulin treated surgery- with major surgery
Emergency surgery
The exact management of such patients is known as “perioperative diabetes management”. In this approach insulin therapy is given in combination with dextrose and potassium. Sourgery.me patients are managed with diet modification only; others are treated with oral medicines. One of the most important precautions is monitoring blood glucose before and after surgery.
Latest reports on diabetes mortality and morbidity rates before and after surgery are lacking. Advances in medical technology accompanied with public intervention and awareness will improve the fate of diabetes patients in the near future.