Management of Diabetes in the Perioperative Period

Diabetes mellitus (DM) is a common problem in anaesthetic practice since over two per cent of surgical patients are concerned. One fourth are insulin-dependent (IDDM) and three fourth non insulin dependent diabetes (NIDDM), according to a large French anaesthetics survey [1]. This frequency is strongly increasing [2]. During a long period, the anaesthetic management has been focused on the glycaemic control, and several regimens have been proposed to obtain a tight perioperative control of glycaemia, even if this necessity remains unproved [3]. Progress in insulins, bedside monitoring of glycaemia and constant infusion techniques have pushed into the background the risks due to glycaemic impairments during the operative period [2].