 SPECIAL SITUATIONS :
Surgery in Diabetes
With optimal preoperative care, surgery can be safely undertaken in diabetics. Necessary surgical procedures should never be avoided due to one's diabetic status.
IT IS IMPORTANT TO EMPHASIZE THAT WITH OPTIMAL CARE, SURGERY IS AS SAFE FOR A DIABETIC, AS FOR A PATIENT WITHOUT DIABETES.
General Principles in management
- Pre-operative assessment
- Day prior to surgery
- Morning of the surgery
- During surgery
- Postoperative care
Clinical Management Scenarios
- Well controlled Type II patient
- Minor surgery, not requiring overnight fasting>font
- Minor surgery with overnight fasting
- Major surgery requiring overnight fasting
Poorly controlled Type II patient
- Non emergency surgery
- Moderately urgent surgery
- Urgent surgery
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Pregnancy in Diabetes
ALL PREGNANT WOMEN MUST UNDERGO TESTING TO RULE OUT GDM. Diabetes in pregnancy falls into two main categories:
Pregnancy in a woman with known NIDDM
WITH OPTIMAL MANAGEMENT PRIOR TO, AND THROUGH-OUT PREGNANCY, WOMEN WITH NIDDM CAN HAVE A PREGNANCY IN WHICH THE COMPLICATION RATES APPROACH THOSE ASSOCIATED WITH A "NORMAL" PREGNANCY
General Considerations
- The importance of a "planned" pregnancy
- Pre-pregnancy management
- Management during pregnancy
- Management during labor
- Hypoglycemia in the new born
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Gestational Diabetes (GDM)
- What is gestational diabetes?
Gestational Diabetes is defined as carbohydrate intolerance of variable severity with its onset, or first recognition, during pregnancy.
- Diagnosis of gestational diabetes
- Women at High Risk for GDM
- Management of gestational diabetes
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