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Section IVOther important drugsDiabetes Type II
Medication Long-acting tablets
Operation Minor
Action Transfer to short-acting tablets 1 week before surgery. Omit tablets on
morning of operation. First on list. Treat as non-diabetic if blood sugar
<7 mmol.l−^1 .Restart tablets with first meal.
Diabetes Type II
Medication Long-acting tablets
Operation Major
Action Treat as Type I diabetes. Once eating convert to soluble insulin before meals
and revert to tablets when total insulin requirement is <20 i.u.day−^1.
Diabetes Type I
Medication Insulin
Operation Major or minor
Action Alberti regime or insulin sliding scaleAlberti regime
Infusion of 500 ml 10% dextrose with 10 i.u. actrapid and 10 mmol KCl starting at 100
ml.h−^1 .Blood sugar and potassium are measured every 2 hours and if adjustments
are required a new infusion is prepared.Insulin sliding scale
An infusion of 10% dextrose at 100 ml.h−^1 is given alongside an infusion of soluble
insulin. The starting hourly insulin rate is calculated by dividing the total daily units
by24. Blood sugar is measured hourly and the insulin rate is adjusted accordingly.