Author/Editor		Barovič, V
Title		Prioperative management of diabetes mellitus in outpatient vitreoretinal anaesthesia and surgery
Type		članek
Source		In: Zabavnik Z, editor. Book of lectures of the 16th anaesthesia symposium Alpe Adria; 2003 May 9-11; Maribor. Maribor: Splošna bolnišnica,
Publication year		2003
Volume		str. 41-8
Language		eng
Abstract		The glycemic control and maintaining metabolic steady state is difficult in the diabetic patients undergoing vitreoretinal surgery. The goals of the study were to find the correlation between the values of HbAlc in diabetics; undergoing outpatient vitreoretinal surgery, and controllability of patients blood sugar levels during and after surgery. The aim of the study was to find the appropriate way of managing glycemic control that should prevent hypoglycemia, ketosis and protein breakdown during surgery . Management of blood sugar during surgical procedures was provided by fixed intravenous infusions of insulin, dextrose and potassium and variable rate intravenous infusions of insulin and separate infusions of dextrose. The second insulin regimen prevented extreme blood sugar levels in patients in not so good glycemic control. The results have also confirmed the hypothesis of reciprocal correlation between HbAlc levels and controllability of blood sugar levels in diabetic patients in good glycemic control. The single value of percentage of glycated hemoglobin (HbAlc) can be the indicator how is diabetes has been controlled over the past three months before the surgery. Higher values of HbAlc indicate more problems in managing inoperative blood sugar levels, frequent rechecking of blood glucose levels and careful adjustment of insulin infusion rate. HbAlc can be a useful tool, besides pre-breakfast value and individual hypoglycemic value of blood sugar that can predict the problems in managing perioperative glycemic control in diabetic patients undergoing the outpatient retinal surgery and vitrectomy.
Descriptors		DIABETES MELLITUS DIABETIC RETINOPATHY ANESTHESIA VITRECTOMY INSULIN HEMOGLOBIN A, GLYCOSYLATED BLOOD GLUCOSE