🩸 Perioperative / Stress Glycaemic Management
Inpatient and perioperative glucose targets, pre-op antidiabetic adjustment, steroid-induced hyperglycaemia and insulin-infusion points, per ADA inpatient standards. Browser-side.
Perioperative / Stress Glycaemic Management
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When to use
Bedside reference for glycaemic targets and how to adjust diabetes medications around surgery.
How it works
Critically ill 140–180 mg/dL; non-critical pre-meal < 140 / random < 180; avoid < 70. Hold metformin on surgery day; stop SGLT2 inhibitors 3–4 days pre-op.
Key points
- Insulin is the only recommended perioperative glucose-lowering agent.
- Reduce basal insulin to 75–80% and hold prandial insulin while NPO.
- Steroid hyperglycaemia is mainly post-prandial; match insulin to the steroid.
- Give basal insulin before stopping an infusion to prevent rebound.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.