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The author reflects on the impact of dysglycemia on perioperative management. He stresses the importance of glucose monitoring and quality control of bedside glucose measurement during the dynamic perioperative period. The author further emphasizes the significance of establishing practice guidelines and applying them globally to complex perioperative cases.

Several letters to the editor are presented in response to articles in previous issues including one on revisiting screening for Type 2 diabetes mellitus by A. M. Sheehy and colleagues in the January 2009 issue and another on screening for diabetes relative to increased risk of macrovascular complications associated with the metabolic syndrome.

Viral sequence variation frequently plays an essential role in viral replication and pathogenesis. HIV particles carrying this enzyme yield minus-strand reverse transcripts in which multiple cytosine (C) residues are deaminated to uracil (U). Sequence variation may also arise through the post-synthesis editing of RNA or DNA. To determine whether other APOBEC proteins can mutate HIV and/or regulate infectivity, wild-type or vif-deficient (Δ vif) viruses were produced in the presence of various family members, and viral infectivities were measured. Thus, HTV RNA as well as DNA can be a substrate for APOBECmediated deamination, making it plausible that C-to-U editing of either could contribute to the sequence diversity that marks natural HIV infection.

Purpose: Physicians can play an important role in shaping health policy. The purpose of this study was to determine characteristics of physicians participating in health policy and barriers and facilitators to their advocacy., Methods: A modified previously validated survey instrument was mailed to physicians affiliated with the University of Wisconsin on October 12, 2018. Three follow-up emails were sent, and the response period closed January 30, 2019. Twenty-eight items were included in the survey tool. Respondents were considered highly engaged if they: (a) reported involvement in predetermined high impact areas, (b) had self-reported weekly or monthly advocacy involvement, or (c) had more than 10% dedicated work time for advocacy., Results: Eight hundred eighty-six of 1,432 physicians responded (61.9%), of which 133 (15.0%) were highly engaged. Highly engaged respondents were more commonly male (57.1%), White (90.2%), of nonsurgical specialties (80.5%), and Democrat (55.6%) or Independent (27.1%). Those not highly engaged were more likely to report "I don't know how to get involved." Less than half of all respondents received any advocacy education, with professional organizations providing the majority of education through conferences and distribution of materials. Only 2.5% of respondents had more than 10% of work time dedicated to health policy., Conclusions: Engagement in health policy exists on a spectrum, but only a small percent of physicians are highly engaged, and very few have dedicated work time for advocacy. Certain demographics predominate the advocacy voice, and health policy training opportunities are lacking., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)