Management of the Perioperative Diabetic Patients

Dear Colleagues, 

Diabetes mellitus is a growing concern worldwide: according to current projections, the prevalence will rise from 387 million people now to 592 million people in 2035 worldwide. Because diabetes mellitus is accompanied by macro- and microvascular complications, patients are more likely to be admitted to a hospital, which translates to a prevalence of diabetes mellitus in hospitalised patients of up to 40%. Furthermore, the annual risk of needing surgery is increased two to six fold in patients with diabetes mellitus as compared to patients without diabetes mellitus.

The association between hyperglycaemia and postoperative complications is firmly established in all surgical patients, including intensive care patients. Guidelines recommend blood glucose to be controlled below 10 mmol/L or even lower down to 7–8 mmol/L. However, implementation of strict perioperative glucose regulation is frequently hindered by low adherence to labour-intensive protocols requiring frequent blood glucose measurements and insulin administrations, as well as the risk of hypoglycaemia. Newer treatment options, like Glucagon-like peptide 1 receptor agonists or sodium-glucose cotransporter-2 inhibitors and others, have been introduced, and have positive effects not only on glycaemic control but also on cardiovascular morbidity.

There is need for future research to establish the optimized treatment of the surgical patient in the perioperative period, including a spectrum of patients ranging from ambulatory minor surgery to major abdominal and cardiac surgery along with intensive care treatment.

We invite experts in the field and research groups to contribute original research work as well as meaningful reviews to this Special Issue of Journal of Clinical Medicine on “Management of the perioperative diabetic patients”.

Prof. Dr. Benedikt Preckel
Guest Editor

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• insulin resistance
• stress hyperglycemia
• glucagon-like peptide 1 receptor agonists
• sodium-glucose cotransporter-2 inhibitors
• metformin
• insulin
• continuous perioperative glucose monitoring
• diabetes and coagulation
• surgical site infections in diabetic patients
• diabetes and neurometabolism