Guidelines - Management of adults with diabetes undergoing surgery and elective procedures: improving standards

Ketan Dhatariya, Daniel Flanagan, Louise Hilton, Anne Kilvert, Nicholas Levy, Gerry Rayman and Bev Watson

NHS Diabetes, April 2011

These guidelines have been commissioned by NHS Diabetes and written by the Joint British Diabetes Societies Inpatient Care Group and representatives from the specialist societies surgeons and anaesthetists. The document has also been informed by focus groups from Diabetes UK. The aim of the guidelines is to improve standards of care for people with diabetes undergoing operative or investigative procedures requiring a period of starvation.

Target audience

The guidelines emphasise the need for patient centred care at every stage and we hope that they will be of use to all healthcare professionals whose work brings them into contact with this vulnerable group of patients.

The target audience specifically includes:
• General practitioners, practice nurses and district nurses
• Pre-operative assessment nurses
• Anaesthetists
• Surgeons
• Trainee medical staff
• Post-operative recovery and surgical ward nurses
• Diabetologists
• Diabetes inpatient specialist nurses, diabetes specialist nurses and educators
• Hospital pharmacists
• Hospital managers
• Commissioners
• Patients.

Most importantly, this document is addressed to those writing and implementing local perioperative care policies and to medical and nursing educators. Managers have a responsibility to ensure that guidelines based on these recommendations are put in place. The guidelines aim to cover all stages of the patient pathway but are not designed to be read from cover to cover. Recommendations for each stage are intended to stand alone so that individual health care professionals can identify their role in the process.

These are the first UK national guidelines in this area of diabetes care and the first to address the whole pathway from referral to discharge. They will be a resource for those responsible at every stage of the pathway for the care of the surgical patient with diabetes.

We wish to congratulate the authors on producing clearly written, comprehensive, practical and easy to follow documents in a complex area of diabetes care. We thoroughly recommend the guidelines to diabetes, surgical, anaesthetic and primary care colleagues.

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