Anesthetic Implications of Diabetes Mellitus

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Anesthetic Implications of Diabetes Mellitus

• Donald M. Voltz, MD
• Assistant Professor of Anesthesiology
• Case Western Reserve University / University
  Hospitals of Cleveland
• 22 September 2004

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Whether you think you can or think you cant
You are right. Henry Ford
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The Greek word Diabetes to Siphon /pass through

...and the Latin word mellitus sweet as honey
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Demographics of Diabetes
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Diagnosis
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Types and Characteristics of Diabetes
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Complications of Diabetes
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DKA
Insulin
IV Fluids
D5W
Potassium
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Hyperosmolar Coma
Renal Failure
IV Fluids
Correct Acidosis
Insulin
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Clinical Scenario
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27 year-old male admitted through the ER with
abdominal pain. Pain is diffuse in nature and is
present with nausea and vomiting for the past 12
hours. Due to the patients complaints and
anorexia, surgery has decided to take this
patient to the operating room for appendectomy.
Upon your evaluation, this patient appears quite
ill, with a respiratory rate of 40/min, blood
pressure of 90/50 mmHg, heart rate of 140/min.
You are the junior attending on call with a first
year resident and decided to perform a general
anesthetic with a rapid sequence intubation.
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D.K.A.
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Diabetes
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Coronary Artery Disease
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Hypertension
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http//www.drbloodpressure.com/graphix/diabetehta.
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End-Stage Renal Disease
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Stiff Joints
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Neuropathy
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Eye
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Perioperative Stress of Diabetes
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Treatment of Diabetes

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Diabetic Treatment Options
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Insulin Response
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Peri-operative Glucose Control