What to do with each diabetes medication the day before and on the day of elective surgery.
Draft — not yet clinically verified. Based on CPOC Guideline for Perioperative Care for People with
Diabetes Mellitus (updated Oct 2023), medication tables 1.1–1.2. Applies to elective surgery with a short
starvation period (no more than one missed meal). Longer fasting, emergency surgery, or HbA1c >69 mmol/mol
→ VRIII pathway instead. Check the UKCPA Handbook for drug-level updates; follow local policy.
On several agents? Check each one in turn — the rules are per drug.
How many doses per day?
Contrast media planned AND eGFR <60?
Centre for Perioperative Care. Guideline for Perioperative Care for People with Diabetes Mellitus
Undergoing Elective and Emergency Surgery. Updated October 2023; medication tables (after JBDS 2016, appendices 2 & 8).
Source: CPOC Diabetes Guideline, October 2023 update.
Scope: elective surgery, ≤1 missed meal. Emergency surgery, prolonged fasting or HbA1c >69 mmol/mol → VRIII.
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