Manejo terapéutico de diabetes mellitus tipo I en el perioperatorio quirúrgico

Abstract

Introduction: The prevalence of patients with diabetes mellitus for surgical interventions is twenty percent and in hospitalized individuals it is twenty-five percent. In addition, diabetes increases the risk of requiring at least one surgery throughout life by up to double. This is because the analysis of therapeutic methods has become a priority due to their complexity of management, especially for surgical processes that predispose them to hypo or hyper glycemia. Objective: To analyze the therapeutic management strategies for patients with Type I Diabetes Mellitus during the surgical perioperative period through a bibliographic review, in order to improve clinical results, minimize perioperative complications and guarantee the safety and well-being of the patient. Procedure: Plan continuous hourly blood glucose monitoring during the perioperative period and adjust insulin doses according to surgery-specific recommendations, which may include the use of basal insulin, meal-based rapid insulin boluses, and level-based corrections. of glucose, the objective is to maintain glycemic control goals. Conclusions: Insulin management during the perioperative period is challenging, but with the availability of insulin analogs without defined peaks, these challenges have been reduced. It is advisable to schedule diabetic patients as the first patient of the day or as early as possible to minimize disruption to their usual insulin doses. Effective insulin management during the perioperative period can improve surgical outcomes.