Complications of diabetes during surgery are varied, but not
Frequent. There are metabolic, cardiovascular and renal complications.
Complications of diabetes during surgery, control metabolic
First we will study the metabolic control of the patient that has to be
Surgically intervened. In the face of poor control, measures will be taken
appropriate to improve it.
Patients with chronic hyperglycemia often present a certain degree of
Dehydration, a situation that must be corrected before the surgical procedure. The
Diabetic patients Type I (insulin-dependent) will be admitted 12-16 hours before
Surgical intervention to optimize metabolic control, patients
Diabetics Type II (non-insulin-dependent) with poor metabolic control also
They’ll be admitted.
This period of 12-16 hours prior to the intervention is extremely
Recommended to stabilize the metabolic situation in diabetic patients
decompensated. A period of 6-8 hours of intensive treatment greatly improves
The general condition of those patients who have disagreements
Severe metabolic (diabetic ketoacidosis or hyperosmolar states do not
Cetósicos) and require urgent surgical intervention.
In some situations this period of time may help to clarify the
Diagnosis, as would be the case of abdominal pain as a result of a
Diabetic ketoacidosis instead of a surgical abdomen.
Complications during surgery, cardiovascular conditions
Diabetic patients can usually have diseases of the
coronary arteries or arterial hypertension. That’s why every diabetic patient
Should undergo a cardiovascular examination that includes the determination of
blood pressure in decubitus and standing to rule out orthostatic, anomaly
Indicative of a cardiovascular vegetative neuropathy.
Controlled hypertension is not a risk for surgery,
But a beta-blocking treatment can minimize the symptoms of
Hypoglycemia, these patients should be monitored. The Diabetic patient
Has a higher risk of thrombosis and therefore it is advisable to
Administer prophylactically 5,000 U of heparin every 8-12 hours while
Renal function and its complications
Preoperative Analytics should include the determination of urea nitrogen in
Blood (BUN), creatinine, electrolytes, and proteinuria. Patients with insufficient
will have problems in the replacement of fluids and electrolytes, in these
Situations the central venous pressure should be monitored.
The presence of hyperkalemia with or without hyponatremia is fairly common in
Patients with moderate renal failure, this alteration in the
Concentration of electrolytes may be the cause of cardiac arrhythmia.
These metabolic disorders are usually secondary to hypoaldosteronism
Hiporeninemico and a diabetic vegetative neuropathy.
If there is a hypokalemia treatment with insulin and glucose without replenishment
of potassium can aggravate your deficit.