J.Jpn. Surg. Soc.. 124(2): 163-167, 2023

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Feature topic

PREOPERATIVE ASSESSMENT AND SURGICAL RISK IN DIABETIC PATIENTS

With the increasing percentage of diabetic patients undergoing surgical procedures, it is important for surgeons to understand their preoperative evaluation and surgical risks. Preoperatively, patients should be evaluated for glycemic control status and the presence of diabetic complications. Diabetic patients have more postoperative complications than nondiabetic ones. Perioperative hyperglycemia increases not only the risk of postoperative infection but also the occurrence of cardiovascular events. On the other hand, hypoglycemia also increases perioperative complications. The risk of postoperative hypoglycemia is particularly high after gastrectomy. Therefore, appropriate preoperative blood glucose control is necessary based on a comprehensive assessment of the urgency and invasiveness of the surgery and the patient’s blood glucose control status. This article describes the necessity of perioperative blood glucose control in diabetic patients, preoperative evaluation items, target values for control, and specific methods of blood glucose control for each diabetic treatment method.

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