Prise en charge des patients diabétiques par les anesthésistes-réanimateurs. Enquête conduite dans un établissement hospitalier universitaire et un centre hospitalier privé

Our aim was to evaluate the perioperative management of patients with diabetes by anesthesiologists and ensure its conformity with professional recommendations, by a survey jointly conducted in a university hospital and a private clinic. The study population involved diabetic patients scheduled for elective surgery on Pontchaillou University Hospital Centre (Rennes, France) or a private hospital of Cesson-Sévigné (France). Data collection was carried out for a period of 3 months using a standardized questionnaire completed by the anesthesiologist in charge of the patient. Questionnaires were completed at the preoperative consultation, in the operating room, and then to the discharge of the patient. Between January and March 2014, 161 questionnaires were collected. The overall completeness, assessed by the Medical Information System Unit is 74%, but with a disparity between surgical specialties. Whatever the type of diabetes and the expected duration of postoperative fasting, a majority of patients have a care in accordance with recommendations (metformin discontinuation, pursuing other antidiabetic agents and insulin, glucose intake, potential relay by insulin before or after surgery). The anesthetic management of patients with diabetes is complex, sometimes difficult, but relatively suitable. Our study shows that the recommendations are fairly applied by anesthesiologists, who can rely on strong therapeutic protocols and widely available in the different units.