Surgical Problems in Diabetes

Question 1

What are the parts of the pre-op evaluation?

Answer 1

Baseline
EKG
Blood Work
Optimize what you can

Question 2

WHat are the important post-op issues in diabetics?

Answer 2

Infections
Wound Care
Glucose Control
Gastroparesis

Question 3

What are the factors that increase infections in diabetic patients?

Answer 3

Reduced Capillary Perfusion
Red O2 and Nutrient Density
Impaired circ of Antimicrobials
Hyperglycemia

Question 4

What are the means of glucose control in the hospital?

Answer 4

Stop oral agents 
Metformin
Effects of Steroids
If sugars over 300 start an insulin drip
Lantus (insulin glargine therapy)
SSI
Don't mix forms of insulin

Question 5

What are the signs of post op MI?

Answer 5

Usually on pain meds so don’t usually feel the pain
Sweating
Acute Dyspnia
Check Cardiac Ez

Question 6

What is Fourniers Gangrene?

Answer 6

Acute Infection of the perineal area.

Question 7

What are the meds that can make blood sugar worse?

Answer 7

Steroids

TPN (IV simple sugars)