Robertshaw H J, Hall G M
Deaprtment of Anaesthesia and Intensive Care Medicine, St George's Hospital, London, UK.
Anaesthesia. 2006 Dec;61(12):1187-90. doi: 10.1111/j.1365-2044.2006.04834.x.
As the incidence of diabetes mellitus continues to increase in the United Kingdom, more diabetic patients will present for both elective and emergency surgery. Whilst the underlying pathophysiology of type 1 and type 2 diabetes differs, there is much good evidence that controlling the blood glucose to < or = [corrected] 10 mmol.l(-1) in the peri-operative period for both types of diabetic patients improves outcome. This should be achieved with a glucose-insulin-potassium regimen in all type 1 diabetics and in type 2 diabetics undergoing moderate or major surgical procedures. After surgery, a decrease in the catabolic hormone response resulting from good analgesia and the avoidance of nausea and vomiting should allow early re-establishment of normal glycaemic control.
随着英国糖尿病发病率持续上升，将有更多糖尿病患者接受择期和急诊手术。虽然1型和2型糖尿病的潜在病理生理机制不同，但有充分证据表明，两类糖尿病患者在围手术期将血糖控制在≤10 mmol·l⁻¹（校正后）可改善预后。对于所有1型糖尿病患者以及接受中大型外科手术的2型糖尿病患者，应采用葡萄糖-胰岛素-钾方案来实现这一目标。术后，良好的镇痛以及避免恶心和呕吐所导致的分解代谢激素反应减弱，应有助于早期恢复正常血糖控制。
