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 aged 18 to 80 years with an established diagnosis of type...

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