Diabetes and surgery
Anesthesia and surgical stress “pump up” the blood sugar - the endocrinologist builds a protocol: temporary transfer to insulin if necessary, target ranges on the morning of surgery, infusion regimens on the day of the intervention, return to home therapy upon discharge. Thyrotoxicosis/hypothyroidism and adrenal insufficiency are managed similarly (hydrocortisone cover). The result is healing and restoration without glycemic swings.
Indications
- diabetes mellitus type 1 and 2 - selection and correction of therapy, complications;
- thyroid nodes and diseases (hypo-/hyperthyroidism, AIT);
- obesity and metabolic syndrome;
- osteoporosis, adrenal and pituitary disorders;
- preoperative compensation of diabetes and thyroid status.
Endocrinologist next to surgery
The key mission here is perioperative compensation: sugar and thyroid status are brought to the goals before the planned operation (safety of anesthesia and healing), schemes are adjusted for the days of intervention. In parallel, a complete outpatient profile: diabetes with training and titration, thyroid nodules according to the protocol (ultrasound with TI-RADS on site, puncture according to indications), obesity with a real plan. The hormone laboratory is in the clinic, decisions are not postponed.
