Diabetes Mellitus in a pre- operative patient: associated risks and complications of general anesthesia Julie L Williams M.D., M.S. CA-1.

Slides:



Advertisements
Similar presentations
Presentation title Emergency Care Part 3: Surgery in Children with Diabetes.
Advertisements

Remission of Korean Non-Insulin Dependent Diabetes Mellitus by Continuous Subcutaneous Insulin Infusion Treatment Konkuk University Diabetic Center Soobong.
Surgery In Diabetes Mellitus (DM)
Preoperative Evaluation of Surgical Patients What Do We Really Need Tomas M Heimann, MD, FACS Chief of Surgery James J Peters VA Medical Center Professor.
Emma Harris Medicines Management Pharmacist West Suffolk Clinical Commissioning Group Educational Event 28 th January 2014 West Suffolk Hospital Education.
Jointly Sponsored by the Sections on: Anesthesiology and Resuscitation Evidence Based Health Care Pediatrics Radiology Urology Why Bother! The Comprehensive.
الجامعة السورية الخاصة كلية الطب البشري قسم الجراحة Perioperative management of the high-risk surgical patient Dr. M.A.Kubtan, MD - FRCS.
Washington State Hospital Association Partnership for Patients Reducing Surgical Site Infections: Glucose Control Clinical Presentation July 10, 2012.
Ryan Hampton January  Risks and benefits of surgery  Timing of surgery  Type of Surgery  Goal is to uncover undiagnosed problems or treat prior.
NATHAN CLEVELAND, MD, MS 2 JULY NATHAN CLEVELAND, MD, MS 2 JULY 2014.
©2014 MFMER | slide-1 Going Against the Grain Improving Processes Related to Patient Comorbidities Alison M. Knight, P.E. IIE 2014 National Conference.
PREOPERATIVE ASSESSMENT OF THE GERIATRIC PATIENT Cheryl Hinners M.D.
Screening for Prediabetes Kelly Moore, MD, FAAP IHS Division of Diabetes Treatment & Prevention.
Diabetes Mellitus Type 2
Oral Glucose Tolerance Test By: Dr. Beenish Zaki Date: 09/05/2012 Senior Instructor Department of Biochemistry.
Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery 2007 ACC/AHA and 2009 ESC GUIDELINES.
Hemoglobin A 1c in Hemodialysis Patients Source: Ix JH. Hemoglobin A1c in hemodialysis patients: Should one size fit all? Clin J Am Soc Nephrol. 2010;5:1539–1541.
Diabetes Mellitus and the Surgical Patient Dr. Cathy Code Division of General Internal Medicine.
Routine screening tests Hai Ho, M.D.. Most expensive part of medical practice? Your Pen.
Surgical treatment for morbid obesity
Perioperative Testing
Preparing Patients for the Operating Room Sugong Chen June 22, 2015.
Clinical Update in Type 2 Diabetes A Case Discussion Dr. Yancey R. Holmes, MD, FACE Ohio Valley Endocrinology.
HCS Objective To determine if measurement of postprandial TG level improves risk prediction of CV events over traditional risk markers in stable patients.
Clinical Chemistry MLCC-201 Clinical Chemistry MLCC-201.
Diabetes Mellitus Primary Care QI Project – Year III Mary Altier, RN, Bonnie Fiala-Bayser, Ph.D., William Cannon, MD, David Goldberg, MD, Jan Jandrisits,
Diabetes update Gillian Clarke Diabetes Lead/Advanced Dietitian.
Perioperative and Consultative Medicine Pamela J. Pride MD, FHM Medical University of South Carolina 2/7/2012.
The Association between blood glucose and length of hospital stay due to Acute COPD exacerbation Yusuf Kasirye, Melissa Simpson, Naren Epperla, Steven.
PREOPERATIVE ASSESSMENT Diabetic patients. Preoperative assessment of diabetic patients When considering the diabetic patient for surgery it is essential.
Impact of Diabetes on Cardiovascular Risk C.Richard Conti M.D. MACC Oct 16,2004 GWICC Beijing, PRC.
Gary Minto Consultant Anaesthetist HOW DO WE ASSESS PATIENTS FOR MAJOR SURGERY?
Preoperative Hemoglobin A1c and the Occurrence of Atrial Fibrillation Following On-pump Coronary Artery Bypass surgery in Type-2 Diabetic Patients Akbar.
1- Blood glucose > 120 mg/dl (6.8 mmol/L) on two repeated measurements. Normal range for blood glucose mg/dl ( mmol/L). boarderline concentrations.
British Association of Day Surgery How can day surgery be a high quality option for the elderly patient? Dr Anna Lipp President British.
Diabetic Profile Measurement of Blood Glucose T.A. Bahiya Osrah.
Evaluation of the Cardiac Patient Before Non-Cardiac Surgery
Circulation. 2014;129: Association Between Plasma Triglycerides and High-Density Lipoprotein Cholesterol and Microvascular Kidney Disease and Retinopathy.
Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010.
ANS Unit 4 The Surgical Client Surgery Involves entering tissue and removing or reconstructing structures that are diseased, injured or malformed.
Safety and efficacy of insulin guideline for controlling perioperative hyperglycemia Marwa Amer PharmD Candidate1, Mark Shelly MD2, Dianne Lee PharmD Candidate1,
Fig. 1 Examples of Insulin pump systems
Copyright © 2012 American Medical Association. All rights reserved.
DIABETES affects: CONCLUSIONS
Diabetes and Risk of CV Outcomes
Program Goals. Inhaled Insulin: Overcoming Past Obstacles With Advances in Understanding.
Clinical recommendations in the management of the patient with type 1 diabetes on insulin pump therapy in the perioperative period: a primer for the anaesthetist 
Management of perioperative hypertension
Improving Surgical Patient Safety
New developments in the preoperative evaluation and perioperative management of coronary artery disease in patients undergoing vascular surgery  Stephen.
Incidence of CV Events in Subjects With T2D vs the Nondiabetic CAD Population
Program Goals. What Will the Emerging Basal Insulin Products Mean for My Diabetes Practice?
Management of diabetic patients undergoing elective surgery
Principal recommendations
Incidence of CV Events in Subjects With T2D vs the Nondiabetic CAD Population
Neel R. Sodha, MD, Frank W. Sellke, MD 
How to evaluate patients with OSA postoperatively
Younger Patients With Type 1 Diabetes: Can We Optimize Their Insulin Therapy?
Panelists. Cardiovascular Risk Modulation in Diabetes: Emerging Pathways and Insights.
Strict versus liberal target range for perioperative glucose in patients undergoing coronary artery bypass grafting: A prospective randomized controlled.
New Lipid-Lowering Guidelines
Perioperative cardiac events in endovascular repair of complex aortic aneurysms and association with preoperative studies  Guilherme L. Bub, MD, Roy K.
Comparative early and late cardiac morbidity among patients requiring different vascular surgery procedures  Gilbert J. L'Italien, BS, Richard P. Cambria,
Long-term survival after vascular surgery: Specific influence of cardiac factors and implications for preoperative evaluation  Martin R. Back, MD, Fabian.
WILLIAM K. FREEMAN, M. D. , RAYMOND J. GIBBONS, M. D
Statin Selection in Patients With Pre-Diabetes: Case Considerations
The role of a defined protocol for cardiac risk assessment in decreasing perioperative myocardial infarction in vascular surgery  T.J. Bunt, MD  Journal.
Gold Bar Performance Data CA Office of the Patient Advocate Report
Neurological complications in carotid body tumors: A 6-year single-center experience  Indrani Sen, MS, Edwin Stephen, MS, Karthik Malepathi, MBBS, Sunil.
PowerPoint 16:9 Screen Ratio Template *
Presentation transcript:

Diabetes Mellitus in a pre- operative patient: associated risks and complications of general anesthesia Julie L Williams M.D., M.S. CA-1

Assessing severity of DM Gold standard: HemoglobinA1c Goals 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 Habitus Type 1 vs. Type 2 Pharmacologic 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 EKG CMP fasting and post prandial blood glucose Urinalysis CBC

ASA/ACA guidlines