Anesthetic Management of Patient with Diabetes Mellitus

The prevalence of diabetes mellitus is steadily increasing throughout the world and in India, the prevalence of diabetes varies from 15 % to 20 % of the adult population. The age of onset of diabetes is also coming down in India. Inevitably, more and more number of diabetic patients require surgery and hence anesthesia. Perioperative glycemic control and end-organ effects of diabetes influence the surgical outcome and prognosis of the patient. By proper pre-anesthetic evaluation and risk assessment, good anesthetic techniques, meticulous glycemic control and efficient postoperative management, anesthesia can be made safe in diabetic patients. Perioperative management of diabetic patients can be classified in to pre, intra and postoperative management. Due to the rising prevalence of diabetes, the provision of safe anaesthesia for these patients will become increasingly important. Type 1 diabetes always requires the administration of insulin and type 2 patients undergoing moderate or major surgery will require conversion to an insulin regimen during the perioperative period.