Type 1 Diabetes Overview and Perioperative Management

Orthop Clin North Am. 2023 Jul;54(3):287-298. doi: 10.1016/j.ocl.2023.02.001. Epub 2023 Apr 7.

Abstract

Type 1 diabetes (T1D) is an increasingly common condition. Although often more effective, treatment regimens for patients with T1D have become more variable and complex with newer insulin analogues and increasing use of diabetes technology. Both surgery and anesthesia are known to trigger a stress response that causes dramatic metabolic changes in the patient that tend to increase glucose variability. Close monitoring of glucose levels and clear algorithms for insulin administration can ameliorate these characteristic responses. As T1D treatment technology becomes more effective at maintaining glucose in target range, there should be more consideration of using this technology during hospitalization and surgery.

Keywords: Continuous glucose monitoring systems; Hybrid closed-loop; Insulin infusion systems; Perioperative care; Surgery; Type 1 diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 1* / drug therapy
  • Glucose / therapeutic use
  • Humans
  • Insulin / therapeutic use
  • Insulin Infusion Systems

Substances

  • Blood Glucose
  • Insulin
  • Glucose