Perioperative Glucose Control in Neurosurgical Patients

Table 2

Preoperative evaluation of the neurosurgical patient.

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(i) Type II diabetics, noninsulin dependents: stop all oral

antidiabetic agents. In elective surgeries, hold oral antidiabetic

agents 24 hours before intervention especially those such as

chlorpropamide with a long half-life.

(ii) Type II diabetics, insulin dependents: for elective short

procedures (<2 hours), suspend regular insulin. Administer

only 2/3 of the long-acting insulin (NPH) or give the full dose of

basal insulin (glargine, levemir), and start nutrition 12 hours after

surgery.

(iii) Type I or II diabetics: for long surgeries or emergencies:

only use regular insulin according to unit’s protocol.

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