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Managing diabetes mellitus in the surgical patient

Kathryn E Coan, Heidi A Apsey, Richard T Schlinkert, Joshua D Stearns & Curtiss B Cook

Patients with diabetes mellitus (DM) who undergo surgery experience higher morbidity and mortality than patients without DM. Hyperglycemia is a determinant of risk for surgical complications. Data are limited about whether controlling glucose improves outcomes, but current information supports treating high glucose levels throughout the continuum of surgical care. Despite its high-profile nature, little is known about the quality of care provided to patients with DM undergoing surgery, and no consensus standards exist on how to manage these patients throughout the surgical continuum. Here we provide an overview of DM and surgery, discuss what is known about glycemic control and its relationship to surgical outcomes in noncritically ill patients, review results of efforts to standardize their care, and highlight areas requiring further study and discussion