RT Book, Section A1 Feldman, Leonard A2 Cohn, Steven L. SR Print(0) ID 1179531122 T1 Diabetes Mellitus T2 Decision Making in Perioperative Medicine: Clinical Pearls YR 2021 FD 2021 PB McGraw Hill PP New York, NY SN 9781260468106 LK accessmedicine.mhmedical.com/content.aspx?aid=1179531122 RD 2024/03/28 AB According to the 2020 National Diabetes Statistics Report, approximately 34 million Americans, 13% of the adult population, have diabetes mellitus (DM). Only 27 million of those patients know they have DM. Adults 65 years old and older make up almost half of the DM cases, and adults 46–64 years old constitute the other half. Moreover, we estimate that another 88 million Americans have prediabetes. You will encounter perioperative hyperglycemia. Twenty to forty percent of patients undergoing general surgery have perioperative hyperglycemia while 80% of patients experience hyperglycemia after cardiac surgery.1 Up to 30% of patients with postoperative hyperglycemia will have no prior history of DM. Their hyperglycemia is due to undiagnosed DM or the effects of the counter regulatory hormones secreted during surgery. The stress of surgery induces the secretion of hormones like catecholamines, cortisol, glucagon, and growth hormone. These hormones induce the release of inflammatory cytokines and overall lead to a cascade of effects that result in a state of relative insulin resistance. This chapter will review preoperative evaluation and perioperative management of the patients with DM undergoing noncardiac surgery.