Search Results

treatment regimen should include healthy eating, weight control, and physical activity; medications are always secondary. 1 When lifestyle changes alone are not sufficient to improve blood glucose levels, oral medications, with or without insulin, are the next logical step in treatment. These drugs will be discussed in groups or classes. The following are the 7 most common classes of drugs in current use for the treatment of hyperglycemia associated with type 2 diabetes. Sulfonylureas are the oldest class of oral antihyperglycemic agents; they were first

Therefore, when accounting for the additional hyperglycemia that is often induced as a result of surgical stress, it is prudent to assume that many ambulatory surgical patients will be in a prediabetic state. Table 1 Hemoglobin A1c Levels and the Distinction Between Normal Glycated Hemoglobin, Prediabetes, and Diabetes Table 2 Conversion of HbA1c in Percentages to Estimated Average Glucose Levels in mg

Dental treatment, 185 Dentistry, 31, 139 Desflurane, 42, 91 Diagnosis of anaphylaxis, 160 ED 95 , 147 Ehlers-Danlos syndrome, 204 Electrocautery, 95 Electromagnetic interference, 95 Electrosurgery, 95 Emanuel syndrome, 201 Emergency medicine, 62 Epinephrine, 17, 71 Gag reflex, 181 General anesthesia, 31, 91, 156, 201 Health care quality improvement, 192 Hemoglobin A1c, 208 Hyperglycemia, 208 Hypermobility type, 204

Dentistry, 244 Dexmedetomidine, 88, 221, 230 Dexamethasone, 136 Drug interactions, 253 Early childhood caries, 212 ECC, 212 Epinephrine, 221 Fasting duration, 226 Gastroesophageal reflux disease, 248 General anesthesia, 3, 29, 144, 162, 165, 226, 235, 248, 251 General anesthesia for elderly, 88 Hemodynamics, 226 Hyperglycemia, 39 Hyperthyroidism, 173 Hypoglycemia, 39

. Additionally, insulin promotes glucose uptake by facilitating the transport of glucose, the primary substrate for cellular metabolism, across the cellular membrane. 4 Diagnosis of T1DM varies between children and adults. Children with T1DM typically present with symptoms of hyperglycemia, the onset of which can be rather sudden and can escalate to a medical emergency in situations involving a delay in diagnosis or treatment. 5 Pediatric patients commonly present with polydipsia, polyuria, and polyphagia secondary to osmotic diuresis. This can progress to include

resume normal dosage. Diabetes Mellitus Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. 8 Two major types of diabetes mellitus are known, reflecting differences in the origin and pathophysiology of the disease. Type 1 was formerly known as juvenile-onset diabetes or insulin-dependent diabetes mellitus (IDDM). Type 2 was formerly labeled maturity-onset diabetes or non–insulin-dependent diabetes mellitus (NIDDM). This dated

, when weighed against the potential for postoperative infection and hyperglycemia, is unknown. This analysis identified 56 trials from 18 countries. The predominant glucocorticoid administered was dexamethasone. No effect on wound infection or length of hospital stay was identified. A rise in peak postoperative glucose concentration averaging 20 mg/mL was noted; however, this increase is probably of little clinical importance. The authors conclude that the perioperative administration of single-dose glucocorticoids for the prevention of postoperative nausea and

was detected 15 minutes after administration of dexmedetomidine, but the small decreases observed in potassium levels appear to be unrelated to dexmedetomidine administration. These preliminary findings warrant further investigation. Comment: The effect of dexmedetomidine on blood glucose concentrations is poorly defined. Physiologic models predict hypoinsulinemia and hyperglycemia following administration; however, published reports suggest cortisol levels are decreased, resulting in reduced blood glucose levels. Hypokalemia has been observed in over 2% of

and therefore does not require a metabolic process to alkalinize. 8 Normal saline (0.9% NaCl) may also be used as an intravenous fluid provided large volumes are not infused. In consideration of acid-base equilibrium, we should therefore use crystalloid solutions buffered with acetate or bicarbonate or plain 0.9% normal saline rather than lactated solutions in patients with MELAS who have impaired lactate metabolism. Glucose administration during surgery was also considered necessary because hypoglycemia promotes hyperlactacidemia. However, hyperglycemia may also