J Anesth Perioper Med. 2017;4(6):282-290. https://doi.org/10.24015/ebcmed.japm.2017.0083

Perioperative Glycemia Control: Have We Reached the Target?

Qian Ding1, Linong Yao1, Jordan Goldhammer2, Hong Liu3, and Jianzhong Sun2

From the 1Department of Anesthesiology and Critical Care, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China; 2Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA; 3Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, Sacramento, CA, USA.

Correspondence to Dr. Qian Ding at dingqian@fmmu.edu.cn, or to Dr. Jianzhong Sun at jian-zhong.sun@jefferson.edu.

EBCMED ID: ebcmed.japm.2017.0083 DOI: 10.24015/ebcmed.japm.2017.0083


Abstract

Aim of review
Perioperative hyperglycemia is very common and has been shown to be associated with increased mortality and morbidity in surgical patients, however, optimal control and management of perioperative glycemia remain uncertain.

Methods
We conducted a comprehensive review of current clinical strategies in perioperative glycemic control, focused on preoperative, intraoperative and postoperative glycemic control and their outcome results in the past 2 decades.

Recent findings
The major findings are: 1) Hyperglycemia occurs commonly during the perioperative period and is associated with increased risk for morbidity and mortality. 2) Recent clinical studies have shown that intensive or “tight” glycemic control perioperatively increase the incidence of hypoglycemia and increase mortality. 3) New clinical guidelines favor a moderate or less stringent glucose management in patients undergoing surgery.

Conclusions
Further studies targeting at optimal glycemic managements and improved perioperative and long-term outcomes in surgical patients remain needed. (Funded by the National Natural Science Foundation of China and Science and Technology Development Fund of Shaanxi Province, China.)

Article Type
Review Article

Declaration of Interests
The authors declare no other conflicts of interest.

Acknowledgements
This work was supported by the National Natural Science Foundation of China (81671195), Science and Technology Development Fund of Shaanxi Province, China (2016SF-185).

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