Perioperative Diabetes Management

Optimal glycemic control in the perioperative period decreases the infection rate and other complications [1–6]. The goal is to prevent hyperglycemia, not just to react to it. The traditional practice of writing only for a “sliding scale” as well as the term “sliding scale” should be abandoned [7]. Good glycemic control requires you to be proactive, not just reactive. Think in terms of basal, prandial (mealtime), and correction insulin therapy. Although some concerns have been raised about “intensive” insulin therapy because of the risk of hypoglycemia, this does not negate the benefit of optimal glucose control, the definition of which includes minimizing hypoglycemia [8–12].