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<p>Optimal management of patients with diabetes mellitus during the perioperative phase requires interprofessional communication and organization of health care professionals from different medical specialties. The ultimate goal is to reduce complications, to improve the clinical outcome, and to enforce the well-being of the patient. In order to achieve this, there has to be a&#xa0;structured treatment plan for each phase of hospitalization, from referral until discharge from the hospital. After referral there should be a&#xa0;recommendation which antidiabetic medications should be discontinued before hospitalization. The optimal perioperative glucose target is 8–10 mmol/l (140–180 mg/dl) and is, therefore, a&#xa0;bit higher than during usual care during hospitalization (5.6–10.0 mmol/l [100–180 mg/dl]). With this measure, dangerous hypoglycemia can be prevented. For optimal perioperative management, the duration of the planned operation, the type of diabetes, and the type of insulin treatment have to be determined. Postoperatively the type of nutrition (parenteral or enteral nutrition) and the optimal insulin treatment (intravenous with perfusor or subcutaneous) have to be planned carefully. Before discharge from the hospital, the treatment modality of antidiabetic medications should be determined and a&#xa0;diabetes health care specialist should guarantee that the patient and his family understand and can use the proposed treatment strategy. A&#xa0;follow-up appointment with the general practitioner or the endocrinologist should be organized within 1&#xa0;month after discharge and all the necessary medical material and the medication until the follow-up visit should be in the possession of the patient.</p>

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Perioperatives Management von Menschen mit Diabetes mellitus: Diabetologie

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月5日

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  • Roger Lehmann

摘要

Optimal management of patients with diabetes mellitus during the perioperative phase requires interprofessional communication and organization of health care professionals from different medical specialties. The ultimate goal is to reduce complications, to improve the clinical outcome, and to enforce the well-being of the patient. In order to achieve this, there has to be a structured treatment plan for each phase of hospitalization, from referral until discharge from the hospital. After referral there should be a recommendation which antidiabetic medications should be discontinued before hospitalization. The optimal perioperative glucose target is 8–10 mmol/l (140–180 mg/dl) and is, therefore, a bit higher than during usual care during hospitalization (5.6–10.0 mmol/l [100–180 mg/dl]). With this measure, dangerous hypoglycemia can be prevented. For optimal perioperative management, the duration of the planned operation, the type of diabetes, and the type of insulin treatment have to be determined. Postoperatively the type of nutrition (parenteral or enteral nutrition) and the optimal insulin treatment (intravenous with perfusor or subcutaneous) have to be planned carefully. Before discharge from the hospital, the treatment modality of antidiabetic medications should be determined and a diabetes health care specialist should guarantee that the patient and his family understand and can use the proposed treatment strategy. A follow-up appointment with the general practitioner or the endocrinologist should be organized within 1 month after discharge and all the necessary medical material and the medication until the follow-up visit should be in the possession of the patient.