Perioperative hypoglycemia in patients with diabetes: incidence after low normal fasting preoperative blood glucose versus after hyperglycemia treated with insulin.

Perioperatively, insulin to treat hyperglycemia is administered judiciously to minimize the risk of hypoglycemia. In patients with diabetes in whom preoperative blood glucose levels are on the low end of normal, hypoglycemia risk may be underestimated. This retrospective study enrolled subjects with presenting preoperative blood glucose values in these ranges: 70 to 89 mg/dL (low normal group) and above 249 mg/dL (hyperglycemia-treated group).

Insulin glargine dosing before next-day surgery: comparing three strategies.

Study Objective: To evaluate three evening insulin glargine dosing strategies for achievement of target (100-179 mg/dL; 5.5 - 9.8 mmol/L) and widened (80-249 mg/dL; 4.

Comparison of insulin pump therapy (continuous subcutaneous insulin infusion) to alternative methods for perioperative glycemic management in patients with planned postoperative admissions.

Background: Patients with diabetes who use insulin pumps [continuous subcutaneous insulin infusion (CSII)] undergo surgeries that require postoperative hospital admission. There are no defined guidelines for CSII perioperative use.

Methods: This retrospective single-institution study identified type 1 and type 2 diabetes subjects by electronically searching 2005-2010 anesthesia preoperative assessments for "pump.

Pheochromocytoma presenting with Takotsubo syndrome.

The clinical presentation of Takotsubo syndrome, or apical ballooning syndrome, resembles an extensive anterolateral myocardial infarction with chest pain symptoms and electrocardiographic ST-elevation or T-wave inversion noted in most patients. However, coronary arteries are invariably found to be normal or to display minimal atherosclerotic disease despite modest elevation of cardiac enzymes. Since most cases of Takotsubo syndrome occur after intense physical and/or emotional stress, catecholamine surge appears to be a common underlying mechanism.