Review Article
Perioperative Glucose Control in Neurosurgical Patients
Table 2
Preoperative evaluation of the neurosurgical patient.
| (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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