Table 1 Discrepancies and corroborations between the ADA and other medical societies and clinical anesthesia textbooks. Similarities marked by check mark and discrepancies marked by ‘X’, see text for further details
From: Near-miss hypoglycemia—reflections on perioperative glucose management guidelines in diabetics
American Diabetes Association (ADA) Standard of Care | Anesthetists of Great Britain and Ireland (AAGBI) | Miller’s Anesthesia | Morgan and Mikhail’s Clinical Anesthesiology | Diabetic Perioperative Management, Dogra & Jialal |
|---|---|---|---|---|
1. Target range for blood glucose in the perioperative period should be 80–180 mg/dL | ✔ | |||
2. A preoperative risk assessment should be performed for patients with diabetes due to high risk for ischemic heart disease and those with autonomic neuropathy or renal failure | ||||
3. Metformin should be withheld on the day of surgery | X | ✔ | ✔ | |
4. SGLT2 inhibitors must be discontinued 3–4 days before surgery | ||||
5. Withhold any other oral glucose lowering agents the morning of surgery or procedure and give half of NPH dose or 75–80% doses of long acting analog or pump basal insulin | X | ✔ | X | |
6. Monitor blood glucose at least every 2–4 h while patient is NPO and dose with short- or rapid-acting insulin as needed | X | ✔ | ||
7. There are no data on the use and/or influence of glucagon-like peptide 1 receptor agonists or ultra-long-acting insulin analogs upon glycemia in perioperative care |