By vgreene, 21 February, 2018 Day of surgery strategy: If on insulin, use insulin drip maintained at 1-2 units/h4 w/ D5W at 50-75 cc/h, to maintain BG 100-150 mg/dL
By vgreene, 21 February, 2018 Short-acting insulins. Don’t give on day of surgery, unless BG>200 mg/dL3
By vgreene, 21 February, 2018 Glargine or detemir: Give usual basal insulin day before and day of surgery; though for safety margin, consider ↓ dose by 20%, on surgery day, esp if pt under tight control
By vgreene, 21 February, 2018 Alpha-glucosidase inhibitor or GLP-1 agonist (exenatide): Hold on day of procedure until eating again
By vgreene, 21 February, 2018 Oral agents that can cause hypoglycemia (sulfonylurea, DPP4 inhibitor/other insulin secretagogue): Hold on day of surgery, resume w/ NL diet
By vgreene, 21 February, 2018 Metformin: For sustained release forms, hold starting evening before procedure; for regular form, hold starting day of procedure; resume metformin 48h post-op if NL renal fxn
By vgreene, 21 February, 2018 Day of surgery strategy: Start insulin drip and maintain at 1-2 units/h w/ D5W at 75-100 cc/h, to maintain BG 100-180
