Section 2 - Perioperative care of the patient with diabetes mellitus

Summary

The International Diabetes Federation estimated that in 2008 there were 246 million adults worldwide with diabetes mellitus (DM), and the prevalence is expected to reach at least 380 million by 2025. Diabetes is diagnosed on the basis of criteria agreed by the World Health Organization (WHO) in 1999. Destruction of the pancreatic ß-cells is characteristic of type 1 DM and usually results in an absolute deficiency of insulin. The principles of management of type 1 DM are based on the detailed observations made in two major trials; the Diabetes Control and Complications Trial (DCCT) and the subsequent Epidemiology of Diabetes Interventions and Complications study (EDIC). Hypoglycaemia is a major concern for many type 1 diabetic patients and is usually described as mild, moderate or severe. Most of the increased morbidity and mortality associated with DM is the result of the micro- and macrovascular complications.