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Literature Review
As a complex and persistent healthcare challenge, type 2 diabetes mellitus presents complications associated with surgery-related procedures. There is a high risk of morbidity development post-surgery due to the adverse impact of the condition on the overall health. Therefore, researchers have dedicated their focus on exploring the range of interventions that could help healthcare providers get the chronic condition under control when carrying out surgical procedures.
Maintaining the health of patients with diabetes is complicated and takes consistent and close monitoring associated with surgery. Therefore, it is especially important to determine the procedures that could facilitate effective management and maintenance. The aim of this literature review is to explore four sources on the topic of type 2 diabetes management in surgery patients to identify best practices and determine gaps that should be addressed in the future.
Search Methods for the Review
To collect resources for the review, the search of medical databases such as EBSCO and Medscape was conducted. In addition, Google Scholar was used to finding digital sources that would be relevant to the current problem. The keyword search included the following terms: operative diabetes management, type 2 diabetes perioperative management, diabetes operative interventions, surgical interventions for diabetic patients, surgery in diabetic patients.
To enhance the search, the truncation method was used. It implies the technique associated with entering the root of a word with different endings that would expand the search results. The search for literature was not confined to the time period during which the studies were published to include a diversity of findings and perspectives.
Literature Review of the Articles
The study by Hirsch, McGill, Cryer, and White (1991) aimed to discuss the implementation of pharmacological therapy methods for the management of type 2 diabetes in patients before operative interventions. The population (P) involved diabetic patients who would be subjected to pharmacological therapy (I) compared to no intervention (C) to reach successful outcomes (O) in operative care.
The article is significant to the current research problem as the researchers concluded that the assessment of metabolic processes in diabetic patients was imperative for adjusting in the management of the condition. With the help of consistent management, it is possible to maintain the health of diabetic patients when implementing surgical interventions. The study presents a background for further research about the interventions in the perioperative management of diabetic patients.
The article by Marks (2003) aimed to explore the use of insulin and potassium in diabetic patients undergoing surgery. The population (P) included diabetic patients who would be subjected to the use of insulin intravenously, frequent glucose checks, and adding potassium (I) compared to no intervention (C) to reach successful outcomes (O) in operative care.
The article is significant to the current research problem because the scholars concluded that the suggested interventions should be adjusted to the needs and health status of each patient and adjusting the interventions accordingly. The research by Marks (2003) contributes to the body of literature on interventions for diabetic patients undergoing surgery as it mentions specific interventions that could be implemented for the effective management of diabetes.
The research by Mazer et al. (2020) is among the recent ones, studying the impact of using sodium-glucose cotransporter 2 inhibitors (SGLT2) on diabetic patients in outpatient surgeries. The population (P) included diabetic patients who would be prescribed SGLT2 (I) compared to no intervention (C) to maintain positive outcomes (O) during surgery.
The study is important because it is current and includes evidence for using a particular medication that would address the healthcare challenges associated with type 2 diabetes. The scholars also mention that clinicians would have to use sound judgment when using SGLT2, which points to the need for adequate training of personnel prior to the administration of the medication.
The article by Pasquel (2020) aimed to explore the effectiveness of using Glargine U300 and Glargine U100 for the inpatient management of type 2 diabetes among patients undergoing surgery. The target population included patients diagnosed with type 2 diabetes (P) being prescribed Glargine U300 and Glargine U100 (I) to compare the outcomes of either prescription (C) to facilitate the inpatient management of medicine and surgery (O).
Similar to the research by Mazer et al. (2020), the study by Pasquel (2020) provides reliable evidence for using medication-based control in the management of diabetes among surgical patients. It was found that both U300 and U100 positively contributed to the lower hypoglycemia of diabetic patients undergoing surgery.
Conclusion of the Review
The four studies reviewed in this paper discussed methods intended to manage type 2 diabetes in patients undergoing operative interventions. While the implementation of any intervention depends on the health status and the needs of each patient, the research showed that both prescription medication and maintenance measures could be effective for ensuring the overall well-being of the target population. Further research is needed because type 2 diabetes is a persistent problem that has not been resolved yet, and studying the ways in which the health patients undergoing surgery could be managed.
References
Hirsch, I., McGill, J., Cryer, P., & White, P. (1991). Perioperative management of surgical patients with diabetes mellitus. Anesthesiology, 74, 346-359.
Marks, J. B. (2003). Perioperative management of diabetes. American Family Physician, 67(1), 93-100.
Mazer, C. D., Arnaout, A., Connelly, K. A., Gilbert, J. D., Glazer, S. A., Verma, S., & Goldenberg, R. M. (2020). Sodium-glucose cotransporter 2 inhibitors and type 2 diabetes. Current Opinion in Cardiology, 35(2), 178-186.
Pasquel, F. J. (2020). A randomized controlled trial comparing glargine U300 and glargine u100 for the inpatient management of medicine and surgery patients with type 2 diabetes: Glargine U300 hospital trial. Diabetes Care, 43(6), 1242-1248.
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