May Journal Club: Intraoperative Blood Glucose Control – Current Practices

May 17, 2025 at 1400-1500 EST

Facilitator: Jaimeson Hatch, MSN-ED, RN, CNOR, RNFA

Location: https://us02web.zoom.us/j/9888711789?omn=86394227590

Articles to review:

Carlsson, C. J., Nørgaard, K., Oxbøll, A.-B., Søgaard, M. I. V., Achiam, M. P., Jørgensen, L. N., Eiberg, J. P., Palm, H., Sørensen, H. B. D., Meyhof, C. S., & Aasvang, E. K. (2023). Continuous glucose monitoring reveals perioperative hypoglycemia in most patients with diabetes undergoing major surgery: A prospective cohort study. Annals of Surgery, 277(4), 603–611. https://doi.org/10.1097/SLA.0000000000005246

Galway, U., Chahar, P., Schmidt, M. T., Araujo-Duran, J. A., Shivakumar, J., Turan, A., & Ruetzler, K. (2021). Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery. World Journal of Diabetes, 12(8), 1255–1266. https://doi.org/10.4239/wjd.v12.i8.1255

Herzig, D., Suhner, S., Roos, J., Schürch, D., Cecchini, L., Nakas, C. T., Weiss, S., Kadner, A., Kocher, G. J., Guensch, D. P., Wilinska, M. E., Raabe, A., Siebenrock, K. A., Beldi, G., Gloor, B., Hovorka, R., Vogt, A. P., & Bally, L. (2022). Perioperative fully closed-loop insulin delivery in patients undergoing elective surgery: An open-label, randomized controlled trial. Diabetes Care, 45(9), 2076–2083. https://doi.org/10.2337/dc22-0438

Lee, M. Y., Seav, S. M., Ongwela, L., Lee, J. J., Aubyrn, R., Cao, F. Y., Kalinsky, A., Aparicio Ramos, O., Gu, Y., Kingston, K., Ivanovic, M., Buckingham, B. A., Desai, D., Lal, R. A., Tan, M., Basina, M., & Hughes, M. S. (2024). Empowering Hospitalized patients with diabetes: Implementation of a hospital-wide CGM policy with EHR-integrated validation for dosing Insulin. Diabetes Care, 47(10), 1838–1845. https://doi.org/10.2337/dc24-0626

Rajan, N., Duggan, E. W., Abdelmalak, B. B., Butz, S., Rodriguez, L. V., Vann, M. A., & Joshi, G. P. (2024). Society for Ambulatory Anesthesia updated consensus statement on perioperative blood glucose management in adult patients with Diabetes Mellitus undergoing ambulatory surgery. Anesthesia and Analgesia, 139(3), 459–477. https://doi.org/10.1213/ANE.0000000000006791

Vanderhoek, S. M., Moini, A., Prichett, L., & Wolf, R. M. (2021). Practice patterns of perioperative insulin pump management in pediatric diabetes. Pediatric Anesthesia, 31, 827–829.

https://doi.org/10.1111/pan.14184

Yen, P. M., & Young, A. S. (2021). Review of modern insulin pumps and the perioperative management of the Type 1 diabetic patient for ambulatory dental surgery. Anesthesia Progress, 68(3), 180–187. https://doi.org/10.2344/anpr-68-03-16

Questions we will be answering:

• Why should we use continuous intraoperative glucose monitoring?
• How do personal insulin pumps work?
• What are the risks of continuous insulin pump use during surgery?
• What are the benefits of continuous insulin pump use during surgery?
• What are the recommendations for managing patients intraoperatively who rely on insulin pumps?
• What are intraoperative staff’s roles and responsibilities with managing intraoperative insulin pumps?
• What are the challenges with managing diabetic patients intraoperatively?

Registration not required

Outcomes: Upon completion of this activity, participants in attendance will have knowledge:

• About their role in maintaining diabetic intraoperative patients’ glucose levels
• About the importance of improving diabetic patient outcomes through blood glucose control efforts.

 To earn 1.0 CHs, you must attend the entire event and complete/submit the evaluation.

Those involved with this event have no conflicts of interest

This activity has been submitted to the Association of periOperative Registered Nurses for approval to award contact hours. The Association of periOperative Registered Nurses is accredited as an approver of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. 

Contact Gert Mayes (cgkgmayes@gmail.com) with any questions.