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Anesthesiology Research and Practice
Volume 2011, Article ID 465974, 9 pages
http://dx.doi.org/10.1155/2011/465974
Review Article

Creating a Perioperative Glycemic Control Program

1Department of Endocrinology, Diabetes and Nutrition, Boston University Medical Center, 88 East Newton Street, Evans 201, Boston, MA 02118, USA
2Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510, USA

Received 15 April 2011; Revised 15 June 2011; Accepted 6 July 2011

Academic Editor: Rainer Lenhardt

Copyright © 2011 Sara M. Alexanian et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hyperglycemia in the surgical population is a recognized risk factor for postoperative complications; however, there is little literature to date regarding the management of hyperglycemia in the perioperative period. Here, we detail the strategies that our institutions have employed to identify and treat hyperglycemia in patients with diabetes who present for surgery. Our approach focuses on the recognition of hyperglycemia and metabolic abnormalities, control of glucose levels via insulin infusion when needed, monitoring for hypoglycemia and a comprehensive multidisciplinary approach that provides standardized recommendations for patients at all points in care as they transition from the preoperative clinic into the operating room, and then into the hospital.