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<p>Patients with diabetes mellitus, despite medical advances, often have comorbidities affecting all organ systems. Diabetes is an important, sometimes underestimated factor that increases the risk of postoperative organ damage. These include, among others, postoperative cognitive dysfunction, cardiovascular events, impaired kidney function, wound infections, and sepsis. Patients with diabetes often stay in the hospital longer and have up to a&#xa0;50% higher risk of one year mortality after surgery. Additionally, their long-term quality of life can be affected. One reason for this is often inadequate blood sugar control during the perioperative phase, as well as insulin resistance caused by post-aggression metabolism. Factors such as blood pressure fluctuations or the severity of the inflammatory response in the body can also negatively influence glucose metabolism, as they trigger stress reactions. To reduce the risk of complications during surgical procedures in patients with diabetes, comprehensive and proactive management is very important. The so-called Early Risk Stratification and Strategy (ERSAS) concept plays a&#xa0;key role here. It involves early risk assessment, treatment optimization, and careful planning of measures. Such a&#xa0;holistic approach helps improve care and minimize complications. In recent years, the treatment of diabetes mellitus has significantly improved through new medications and technological innovations. These advancements should also be considered in the planning and execution of perioperative measures. The article demonstrates how the ERSAS concept helps reduce postoperative complications in diabetic patients requiring surgery by enabling interdisciplinary and individualized care.</p>

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Perioperatives Management von Menschen mit Diabetes mellitus: patientenzentriertes anästhesiologisches Management

  • 期刊论文

  • 发表日期：

    2025年12月18日

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  • Vera von Dossow,
  • Janis Fliegenschmidt,
  • Astrid Bergmann

摘要

Patients with diabetes mellitus, despite medical advances, often have comorbidities affecting all organ systems. Diabetes is an important, sometimes underestimated factor that increases the risk of postoperative organ damage. These include, among others, postoperative cognitive dysfunction, cardiovascular events, impaired kidney function, wound infections, and sepsis. Patients with diabetes often stay in the hospital longer and have up to a 50% higher risk of one year mortality after surgery. Additionally, their long-term quality of life can be affected. One reason for this is often inadequate blood sugar control during the perioperative phase, as well as insulin resistance caused by post-aggression metabolism. Factors such as blood pressure fluctuations or the severity of the inflammatory response in the body can also negatively influence glucose metabolism, as they trigger stress reactions. To reduce the risk of complications during surgical procedures in patients with diabetes, comprehensive and proactive management is very important. The so-called Early Risk Stratification and Strategy (ERSAS) concept plays a key role here. It involves early risk assessment, treatment optimization, and careful planning of measures. Such a holistic approach helps improve care and minimize complications. In recent years, the treatment of diabetes mellitus has significantly improved through new medications and technological innovations. These advancements should also be considered in the planning and execution of perioperative measures. The article demonstrates how the ERSAS concept helps reduce postoperative complications in diabetic patients requiring surgery by enabling interdisciplinary and individualized care.