[GmanRN]

Originally Posted by suzanne4

. Many physicians are now ordering glucose checks q am for two days, as they have been finding out that more are diabetics than the patients were aware of pre-op.

Agreed Suzanne.

However Im not sure that the diagnosis of new onset diabetes can always be accurate for an acutely ill patient who is in the hospital. Gluconeogenisis is increased under stress and illness. A patient's blood sugar may return to a lower level once stress and illness is no longer a factor.

I wonder if the CRNAs on this board are seeing hyperglucosemia intraoperatively on patients who had normal glucose levels preop.

Would be nice to know.

G

[suzanne4]

It is not even to make a diagnosis of diabetes, but to make sure that the glucose levels are kept to the normal levels. Stress plays a big part in elevating glucoses, even the surgery alone can do it, and they find better recovery when sugars are kept under control.

Every heart surgeon that I have worked with in the OR in the past few years is doing this. It is actually becoming a standard of practice, there is much in the literature already on this.

[nurseabc123]

Originally Posted by UCDSICURN

I can say I've only seen a couple open hearts come out on insulin drips. Post-operatively we are very aggressive with tight glucose control with a goal less than 140 for at least the first 48 hours, as I can't speak to how tight control is on the floors.

I really can't speak to the why's of the -ologists in the CVOR and why they are behind the times. The surgeons and clinical educators are aware and are working on it, but have yet to see any results.

Hmm... all of our hearts come out on insulin gtts. We follow a tight glycemic control protocol starting in the OR all the way to the med-surg unit.