Journal Article

Perioperative Management of Adult Patients with Diabetes Wearing Devices: A Society for Perioperative Assessment and Quality Improvement (SPAQI) Expert Consensus Statement

Umpierrez, Guillermo E., Duggan, Elizabeth W., Klonoff, David C., Abdelmalak, Basem B., Kalra, Smita K., Urman, Richard D., Charitou, Marina M., Mendez, Carlos E., Sherr, Jennifer L., Russell, Linda L., Grant, Paul J., Patel, Preethi, Oprea, Adriana D., Pfeifer, Kurt J.

2024

Overview

In recent years, the integration of advanced diabetes technology into the care of individuals with diabetes has grown exponentially. Given their increasing prevalence, insulin-requiring people with diabetes may present to preoperative clinics or the operating rooms wearing such devices. While advantageous from a diabetes management perspective, for those unfamiliar with devices this can add another layer of complexity to diabetes management in both the outpatient and inpatient settings, particularly because of the rapidly evolving technology. Therefore, perioperative clinicians need to become familiar with diabetes technological advances, and device features and have an understanding of how they can be used in the perioperative period. This consensus statement aims to serve as an educational material as well as to serve as a guide to perioperative clinicians caring for patients wearing diabetes devices (insulin pumps and continuous glucose monitors). •Diabetes technology is rapidly evolving towards more automated systems for insulin delivery.•While older insulin pumps required considerable user input, newer automated systems simplify diabetes management including during the perioperative period.•Continuous glucose monitoring is not currently FDA approved for in-hospital or perioperative use, but values and trends can be useful in conjunction with point of care testing.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adult / Anesthesia / Blood Glucose - analysis / Blood Glucose Self-Monitoring - instrumentation / Blood Glucose Self-Monitoring - standards / Consensus / Diabetes / Diabetes Mellitus - therapy / Endocrinology / Glucose / Hospitalists / Humans / Hypoglycemia / Hypoglycemic Agents - administration & dosage / Hypoglycemic Agents - therapeutic use / Infusion pumps / Insulin - administration & dosage / Insulin Infusion Systems - standards / Insulin resistance / Internal medicine / Magnetic resonance imaging / Medical personnel / Pain Medicine / Perioperative care / Perioperative Care - methods / Perioperative Care - standards / Quality Improvement