Diabetes Mellitus in a pre-operative patient: associated risks and complications of general anesthesiaJulie L Williams M.D., M.S.

CA-1

Assessing severity of DM

Gold standard: HemoglobinA1c

Goals of <5.5-6%

Often a recent HbA1c is not available...

Evaluate patient in pre-operative clinic setting with basic metabolic panel, accucheck, repeat blood glucose test on morning of surgery.

Body Habitus

Type 1 vs. Type 2

Pharmacologic management

Specific pre-operative concerns

D.M., no matter how well or poorly controlled is a risk factor for CAD and major cardiac event in perioperative setting.

Pre operative testing

EKG

CMP

fasting and post prandial blood glucose

Urinalysis

CBC

ASA/ACA guidlines