Control glucémico en el proceso perioperatorio de los pacientes con diabetes mellitus

the diabetic patients require frequently some type of surgery or the implementation of an invasive diagnostic procedure which may even be carried out as an emergence. nowadays the surgical risk of the diabetic patient has decrease thanks to the advances in the anesthetic techniques and to the perioperative metabolic control, although the complications are more frequent and to generate a lengthy hospitalization and a great disability rate. in the preoperative assessment it is necessary to specify exactly the diabetes's features, the type of surgical procedure, surgical anesthetic risk and to perform the fitting necessary in the habitual treatment. the continuous infusion of intravenous insulin with glucose is the more rational and physiologic method in most of surgical interventions, involving the frequent glycemia monitoring with immediate fittings. some special situations including complicated surgeries or those of emergence, require specific therapeutical schemes, thus each staff must to have its work protocol, according the peculiarities of the surgical interventions performed. the perioperative metabolic control is essential to avoid the metabolic and acute hydroelectrolytic alterations and to favor the satisfactory course during the postoperative period. due its significance, authors carried out a review with the current approach helping to improve the quality of care of diabetic patient requiring a surgical intervention.