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Therapie des Diabetes mellitus in der perioperativen Medizin – ein Update

Treatment of diabetes mellitus in perioperative medicine—an update

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Zusammenfassung

Diabetespatienten, die sich einem operativen Eingriff unterziehen, haben ein erhöhtes Risiko für metabolische Entgleisungen, anästhesiologische Komplikationen, postoperative Infektionen und kardiovaskuläre Ereignisse. Die Therapie des Diabetes mellitus unterliegt der ständigen Weiterentwicklung durch medikamentöse und technische Neuerungen. Der vorliegende Beitrag stellt die Implikationen der aktuellen Konzepte der Diabetestherapie für die perioperative Medizin dar, insbesondere die Veränderungen durch neue orale Antidiabetika und die Insulinpumpentherapie. Einige momentan verfügbare Leitlinien werden in Bezug auf die Betreuung von Diabetespatienten im Kindes- und im Erwachsenenalter rund um eine Operation diskutiert. Abschließend wird auf mögliche Perspektiven im Bereich der Überwachung und Therapie von Diabetespatienten eingegangen.

Abstract

Patients with diabetes who undergo a surgical intervention have an increased risk of metabolic derailment, anesthesiological complications, postoperative infections and cardiovascular events. The treatment of diabetes mellitus is subject to a continuous further development due to pharmaceutical and technical innovations. This article presents the implications of the current concepts of diabetes treatment for perioperative medicine, particularly the changes due to new oral antidiabetic agents and insulin pump treatment. Some of the currently available guidelines are discussed with respect to the care of diabetes patients in childhood and adulthood in connection with an operation. Finally, possible perspectives in the field of monitoring and treatment of diabetes patients are discussed.

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Authors and Affiliations

  1. Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland

    B. Rupprecht & S. Stöckl

  2. Gemeinschaftspraxis Diedorf, Zertifiziertes Diabeteszentrum DDG Dres. Huß, Baur, Ziesing und Kollegen, Bei den Zäunen 2, 86420, Diedorf, Deutschland

    A. Stöckl

  3. Pädiatrische Anästhesiologie, Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum St. Marien Amberg, Mariahilfbergweg 7, 92224, Amberg, Deutschland

    C. Dietrich

  4. Pädiatrische Anästhesiologie, Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Weiden – Kliniken Nordoberpfalz AG, Söllnerstr. 16, 92637, Weiden, Deutschland

    C. Dietrich

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A. Stöckl: Amgen (Studiendurchführung-Honorare), AstraZeneca (Kongressreisen), Berlin-Chemie (Vortragshonorare), Lilly (Kongressreisen), Novo Nordisk (Kongressreisen), Sanofi (Vortragshonorare) B. Rupprecht, S. Stöckl und C. Dietrich geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Rupprecht, B., Stöckl, A., Stöckl, S. et al. Therapie des Diabetes mellitus in der perioperativen Medizin – ein Update. Anaesthesist 70, 451–465 (2021). https://doi.org/10.1007/s00101-020-00875-7

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