Principles of the treatment of surgical diseases in elderly and aged patients with diabetes mellitus
Kuleshov, E.V.
Khirurgiia 7: 34-38
2001
ISSN/ISBN: 0023-1207 PMID: 11521306 Document Number: 535869
Based on his experience of treatment of more than 5000 diabetic patients with surgical diseases, the author describes basic principles of management of these patients before, during and after operation. Combined treatment is based on compensation of diabetes, fluid-and-electrolyte balance and acid-base equilibrium. Blood glucose before operation must be limited to 8.3-8.7 mmol/l, ketoacidosis must be absent. During 3-4 days after operation doses of insulin must increase from 0.4-0.5 to 0.8-0.9 U/kg. Energy value of the diet must be not less than 9375-10,450 kJ bearing in mind glucose administered intravenously. Choice of the anesthetic method which has the least negative influence on carbohydrate metabolism and hemostasis as a whole is analyzed. Diabetic patients with surgical diseases can be operated with favourable outcome only in compensated diabetes and balanced homeostasis.