You are preparing your patient with type 2 diabetes for a three-hour general anesthetic at your ambulatory surgical center. She informs you that she took metformin this morning. Based on a recent study, how would her blood glucose level most likely compare to a similar patient who did not take metformin the morning of surgery?
Diabetic patients undergoing surgery who take oral hypo-glycemic medications are generally instructed not to take them on the morning of surgery. The Society for Ambulatory Anesthesia notes there is a lack of evidence regarding whether to continue or to hold these medications. The Joint British Diabetes Societies suggest continuing metformin if only one meal will be missed. The authors of a recent study evaluated the effect of oral hypoglycemic medication on blood glucose levels when they were continued or held for ambulatory surgery.
Patients...