Towards Optimal Management of Diabetes in Surgery

This book addresses key principles in the optimal management of diabetes to facilitate smooth and safe anesthesia and surgery with the best possible outcomes. It addresses a range of topics, including: diabetic emergencies, glycemic control in emergencies, the routine perioperative setting, preoperative evaluation in routine and emergency surgery, intra- and post-operative management for neurosurgery, cardiothoracic surgery, gestational diabetes, bariatric surgery and other major surgeries. A dedicated chapter on Metabolic Havoc of Uncontrolled Diabetes provides the in-depth understanding of diabetic pathophysiology required in surgical situations, while a special chapter addresses commonly asked questions on surgery and diabetes. Despite many recent advances in surgery, anesthesia, and diabetes research, perioperative diabetes management is often not addressed adequately. This is largely due to an insufficient understanding of insulin physiology and its pharmacokineticsand pharmacodynamics under normal and stressful conditions. The optimal management of surgery in diabetes calls for an integrated, collaborative, and proactive approach. Surgeons, anesthetists and physicians should know the central, basic aspects of perioperative diabetes management and understand the contribution that each one makes to the best outcome, as well as their limitations.