Perioperative management of the diabetic patient

© Springer International Publishing Switzerland 2016. Patients with diabetes mellitus are at increased risk of intra and postoperative morbidity and mortality. Poor glycaemic control in these patients is associated with worse surgical outcomes. Additionally, diabetes mellitus is often complicated by the presence of late chronic complications that may further increase the risk associated to hyperglycaemia. Therefore, diabetic patients require a careful preoperative assessment. However, there is not enough evidence concerning the optimal perioperative glycaemic target and treatment strategy in diabetic patients. Current guidelines provide clinical recommendations on the management of glycaemia based on the limited available evidence. The treatment schedule may vary according to the patient’s individual characteristics and the type and duration of the surgical procedure. The aim of this chapter is give an overview of the available, clinically relevant, evidence on the management of patients with diabetes mellitus undergoing any surgical procedure.