18: Perioperative Management of DM - Kanis

Question 1

**_____ glucose control decreases complications and mortality in patients

Answer 1

tight

Question 2

type I patients should ___ have basal coverage

Answer 2

always, never ever make them go without it

Question 3

*******type I diabetics always require insulin, evn when

Answer 3

euglycemic

Question 4

pt on oral medications –>

Answer 4

hold oral meds

Question 5

short morning procedure, pt on insulin pump

Answer 5

basal rate only

Question 6

short morning procedure, twice daily insulin injection normal routine –>

Answer 6

give 1/2 of AM insulin dose in form of NPH

Question 7

short morning procedure, basal and prandial insulin regimen normally –>

Answer 7

give basal (glargine) insuline and hold prandial (lispro or aspart)

Question 8

long procedure or later in daty —>

Answer 8

insulin and 5% dextrose by continuous infusion

Question 9

***which of the following should be goals when caring for a diabetic pt in the perioperative time period?

Answer 9

A achieve blood glucose control prior to surgery
B provide glucose as a carb to inhibit proteolysis, ketosis and lipolysis, etc
C to provide insulin as appropriate to keep blood glucose less than 200
D to prevent hypoglycemia
E All of the above

Question 10

long acting and short acting, good labs, good angiogram. what should you not do?

Answer 10

NPO at midnight and no insulin in morning

type I always needs insulin!