Anaesthetic management of the patient with diabetes

Diabetes is a metabolic disorder characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism. This results from defects in insulin secretion, insulin action, or both. The effects of diabetes include long-term damage, dysfunction and failure of key organ systems.The prevalence of diabetes is increasing in the UK, standing at 4.3% in 2005, compared to 2.8% in 1996. While the incidence of type 1 diabetes is static, the incidence of type 2 diabetes is rising rapidly. This trend is expected to continue, with some models predicting a prevalence of 9% (range 6.3–13.3%) by 2025.The burdens diabetes places on healthcare are great, both financially and on an individual patient's quality of life. Excellent anaesthetic management of the diabetic patient throughout the operative journey is key to a successful outcome and efficient use of resources.