Do People With Diabetes Need to Fast Longer Before Surgery?

People with diabetes don't have higher gastric volumes than those without diabetes after following standard preoperative fasting instructions, suggested a study from a team of anesthesiologist researchers.

But she added,"If someone has symptoms of gastroparesis or when in doubt, we can always do a gastric ultrasound exam at the bedside and see whether the stomach is full or empty…it's very quick, and it's not difficult to do.", Mark A. Warner, MD, professor of anesthesiology at the Mayo Clinic in Rochester, Minnesota, said the findings"will be very helpful to anesthesiologists," although he noted that the exclusion of people with a BMI > 40 is a limitation.

And regarding the use of gastric ultrasound for those who are symptomatic, Horowitz said,"The relationship of symptoms such as nausea, vomiting, fullness, whatever it may be, with the rate of gastric emptying is weak at best. The association is not simply cause and effect."for allowing clear liquids to be consumed up to 2 hours in advance of anesthesia because it doesn't distinguish between liquids with and without calories.

"The slowing occurs in much lower doses than are used for glucose lowering," Horowitz said."It is very likely that plasma levels will need to be extremely low to avoid gastric slowing. The current guidelines fail to appreciate this. So, to withhold the short-acting drugs for 1 day is probably wrong. And to stop long-acting drugs for 1 week is almost certainly wrong too."

Diabetes Mellitus Type Ii Type 2 Diabetes Type 2 DM T2DM T2D Pain Management Acute Pain Clinical Guidelines Guidelines Stomach Surgery Pain Ultrasonography Ultrasound Sonogram GLP-1 Receptor Agonists Glucagon-Like Peptide-1 Receptor Agonists Anesthesia Anesthetic Anesthaesia Anaesthetic Aspiration Body Mass Index BMI Preoperative

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