Perioperative Medication Management for Patients with Diabetes: Oral Agents, Insulins, Noninsulin Injectables, and Diabetes Devices.

Perioperative management of diabetes medications requires careful coordination to maintain glycemic control while minimizing the risk associated with both hyper and hypoglycemia. Optimal day of surgery blood glucose control requires guidance for oral hypoglycemic agents and home insulin regimens. Most oral and injectable agents require adjustments the day before and day of surgery to account for altered nutrition, the surgical stress response, and the mechanism of drug action. Medications are also individually adjusted based on the type of diabetes, length of NPO period, and invasiveness of the surgical procedure.