Endocrine Care for the Surgical Patient: Diabetes Mellitus,

Med. Clin. North Am. · Nov 2024

Review

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

Patients 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.

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

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