Towards Optimal Management of Diabetes in Surgery

Glycemic Control in Perioperative Setting.- Properties of Intravenous Fluids and their Relevance in Perioperative Setting with Diabetes.- Insulin Pharmacokinetics and Pharmacodynamics.- Nature of Surgical Stress in Surgery.- Intra and Post operative Management of Routine Surgery.- Emergency Surgery and Diabetes Management.- Perioperative Diabetes Emergencies and their Management.- Special Surgical Situations in Persons with Diabetes.- Metabolic Havoc of Diabetic State and its Implications.- Commonly Asked Questions about Surgery and Diabetes.

This book addresses key principles in the optimal management of diabetes to facilitate smooth and safe anesthesia and surgery with the best possible outcomes. It addresses a range of topics, including: diabetic emergencies, glycemic control in emergencies, the routine perioperative setting, preoperative evaluation in routine and emergency surgery, intra- and post-operative management for neurosurgery, cardiothoracic surgery, gestational diabetes, bariatric surgery and other major surgeries. A dedicated chapter on Metabolic Havoc of Uncontrolled Diabetes provides the in-depth understanding of diabetic pathophysiology required in surgical situations, while a special chapter addresses commonly asked questions on surgery and diabetes.

Despite many recent advances in surgery, anesthesia, and diabetes research, perioperative diabetes management is often not addressed adequately. This is largely due to an insufficient understanding of insulin physiology and its pharmacokinetics and pharmacodynamics under normal and stressful conditions. The optimal management of surgery in diabetes calls for an integrated, collaborative, and proactive approach. Surgeons, anesthetists and physicians should know the central, basic aspects of perioperative diabetes management and understand the contribution that each one makes to the best outcome, as well as their limitations.

Sanjeev Kelkar: An MD in Internal Medicine who has worked in many fields of health care, but diabetes has remained his focus for the last three decades. A key figure in India, he has successfully conducted innovative teaching programs for postgraduate doctors in collaboration with the Australian University in Newcastle. He was awarded for this work by the Australian Government and Australian Industry. With a few other doctors he founded the Diabetic Foot Society of India, which has since become recognized throughout the Diabetes World. Improving the understanding of Diabetes and Diabetic Foot among allopaths, paramedics, and doctors from traditional systems of medicine in India through numerous interactive workshops is another of his achievements. He has written and edited many books on Diabetic Foot Management.

Shubhangi Muley: An MD in Anesthesia from AIIMS, New Delhi. After working at AIIMS, she became a Senior Consultant in Neuro and Cardiac Anesthesia and the chief of critical care for nearly eight years at the CIIMS Nagpur. During this time, she worked to develop and adapt many methods for smoothly managing these heavy burdens in simple, straightforward ways, making their management more efficient. Many of these ideas can be found in this volume.

Prakash Ambardekar: A veteran anesthetist who has pioneered, developed and refined the techniques of regional anesthesia particularly in infected diabetic foot surgery in hemodynamically unstable patients with grossly altered vital parameters, as well as other infected lesions elsewhere in the body - innovations that have made these surgeries far safer than under general anesthesia. He has performed thousands of these surgeries with successful outcomes.