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RE: [IP] Re: Surgery

Anesthesiology: Volume 103(4) October 2005 pp 687-694 
Poor Intraoperative Blood Glucose Control Is Associated with a Worsened
Hospital Outcome after Cardiac Surgery in Diabetic Patients
[Clinical Investigations]


John S Wilkinson, 
Rome, New York

-----Original Message-----
From: John S Wilkinson [mailto:email @ redacted] 
Sent: Wednesday, July 12, 2006 6:26 AM
To: 'email @ redacted'
Subject: RE: [IP] Re: Surgery

Sounds more like for the anesthesiologist benefit than the patients.

John S Wilkinson, 
Rome, New York

-----Original Message-----
From: email @ redacted
[mailto:email @ redacted] On Behalf Of Michael
Sent: Tuesday, July 11, 2006 9:58 PM
To: email @ redacted
Subject: Re: [IP] Re: Surgery

> In a message dated 7/11/2006 4:32:16 PM Central America Standard Tim, 
> email @ redacted writes:
> What is  the reasoning for the basal being cut in half? If the basal
> is set properly  the BG won't raise or fall for a long time. On 
> injections the insulin was  cut in half because no food was consumed 
> That would cause you Bg's to drop  low.
> John S Wilkinson,
> Rome, New York
> I wonder if the doctor suggested lowering the basal...  For some 
> reason, my family doctor believes that bg's go low during a surgery, 
> but mine  actually go higher, so that I actually have to INCREASE my 
> basal rate, and for  days afterward.

I have a friend that is an anesthesiologist. We've discussed T1's and 
surgery at some length. His preference is to have bg's around 200 so 
that if something 'bad' happens that requires extraordinary effort on 
his part, that is one less thing to worry about. He won't have his 
patient go low due to shock or whatever... while he's trying to keep 
them stable. He's fine with the pump being on, he just wants some 
margin for error if there is a problem. If the surgery is long and bg's 
rise, he will give insulin as required.

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