Background: Given the prevalence of diabetes mellitus in modern society, health care
providers are frequently tasked with managing glucose control in the perioperative period. When
determining perioperative diabetes management, the clinician must balance the need to maintain
relative euglycemia at the time of surgery with preventing hypoglycemia or hyperglycemia in a
fasting surgical patient. This balance requires an understanding of the pharmacology of these medications,
the type of surgery, and the patient’s degree of diabetic control.
Objective: We discuss the various medications used in the treatment of diabetes mellitus and the
current recommendations regarding perioperative care.
Method: A review of the current literature present on Pubmed and Medline was conducted between
the years 2000-2016. The reference lists of each selected article were also reviewed for additional
sources of information.
Conclusion: Perioperative control of blood glucose levels is associated with less morbidity and
improved surgical outcomes in patients with and without DM. Preoperatively, clinicians need to
thoughtfully adjust diabetic medications on the basis of patient comorbidities, the duration of the
fasting period, and the duration of surgery. Intraoperative and postoperative strategies typically use
insulin to maintain blood glucose levels in the range of 80 to 180 mg/dL.