• Med. Clin. North Am. · Nov 2024

    Review

    Endocrine Care for the Surgical Patient: Diabetes Mellitus, Thyroid and Adrenal Conditions.

    • Carlos E Mendez, Jason F Shiffermiller, Alejandra Razzeto, and Zeina Hannoush.
    • Division of General Internal Medicine, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226, USA. Electronic address: cmendez@mcw.edu.
    • Med. Clin. North Am. 2024 Nov 1; 108 (6): 118512001185-1200.

    AbstractPatients with hyperglycemia, thyroid dysfunction, and adrenal insufficiency face increased perioperative risk, which may be mitigated by appropriate management. This review addresses preoperative glycemic control, makes evidence-based recommendations for the increasingly complex perioperative management of noninsulin diabetes medications, and provides guideline-supported strategies for the perioperative management of insulin, including suggested indications for continuous intravenous insulin. The authors propose a strategy for determining when surgery should be delayed in patients with thyroid dysfunction and present a matrix for managing perioperative stress dose corticosteroids based on the limited evidence available.Published by Elsevier Inc.

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