Caring for patients with diabetes in the outpatient surgical setting: current recommendations and controversies

Curr Opin Anaesthesiol. 2024 Dec 1;37(6):651-660. doi: 10.1097/ACO.0000000000001438. Epub 2024 Sep 19.

Abstract

Purpose of review: Perioperative outpatient (ambulatory) care of the adult patient with diabetes requires unique considerations that vary from the inpatient setting. This review highlights specific pre, intra, and postoperative care steps for patients with diabetes undergoing ambulatory surgery, summarizing recent clinical trials, expert reviews, and emerging evidence.

Recent findings: There is a paucity of evidence examining optimal diabetes management in the outpatient setting. Currently, there are limited studies regarding preoperative management of oral hypoglycemic agents, home insulin, and carbohydrate-containing beverages.

Summary: Future research needs to specifically examine chronic blood glucose control, day of surgery targets, effective home medication management and the risk of perioperative hyperglycemia in ambulatory surgery. Education, protocols and resources to support the care of perioperative patients in the outpatient setting will aid providers on the day of surgery and provide optimal diabetes care leading up to surgery.

Publication types

  • Review

MeSH terms

  • Ambulatory Care / methods
  • Ambulatory Care / standards
  • Ambulatory Surgical Procedures* / adverse effects
  • Ambulatory Surgical Procedures* / standards
  • Blood Glucose / analysis
  • Blood Glucose / drug effects
  • Diabetes Mellitus*
  • Humans
  • Hyperglycemia / etiology
  • Hyperglycemia / prevention & control
  • Hypoglycemic Agents* / administration & dosage
  • Hypoglycemic Agents* / adverse effects
  • Hypoglycemic Agents* / therapeutic use
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Perioperative Care* / methods
  • Perioperative Care* / standards
  • Postoperative Care / methods
  • Postoperative Care / standards
  • Practice Guidelines as Topic
  • Preoperative Care / methods
  • Preoperative Care / standards

Substances

  • Hypoglycemic Agents
  • Blood Glucose
  • Insulin