The chief principle of diabetic management through any crisis in which patients cannot eat or drink for any reason is to continue insulin administration. The best method is to give the insulin by continuous intravenous infusion either by infusion pump or directly from the drip bag.
For operations in which a patient is likely to be maintained on a drip for more than 12 hours a regimen is needed which can be continued for an indefinite period. Again there are two methods of administering the insulin: a variable rate infusion using a pump, or if this is not available, a glucose insulin-infusion. Note:
• The rate of intravenous infusion must depend on the clinical state of the patient with regard to the volume depletion, cardiac failure, age, etc.
• Potassium replacement is required.
• If the blood glucose is persistently above 10mmol/l the infusion should be changed to 0-9% saline.
• Blood glucose should be monitored every one to two hours during surgery and regularly postoperatively.
• Try to maintain the blood glucose concentration in a safe range—6-0-12 mmol/l.
• Regular (at least daily) electrolyte measurements are required.
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All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.