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: HemoglobinA1cGoals 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 HabitusType 1 vs. Type 2Pharmacologic 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

EKGCMPfasting and post prandial blood glucoseUrinalysisCBC

ASA/ACA guidlines