Oral hypoglycemic medications are usually withheld the day of surgery. These medications have a relatively long duration of action, which could lead to hypoglycemia late in the day if the patient’s oral caloric intake is inadequate. For patients with relatively well-controlled insulin-requiring diabetes mellitus and reasonable glucose control (<250 mg/dL), one option is to hold all short-acting insulin and give a portion (one-third or one-half) of the usual dose of intermediate-acting or long-acting insulin the morning of the surgery.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.