Diabetes mellitus (DM) is a disease of impairment in the production of or responsiveness to the pancreatic hormone, insulin. Pediatric patients with diabetes are often deemed to have insulin dependent diabetes (IDDM). Without insulin, children cannot keep their blood glucoses (BG) within a target range. Keeping BGs in a target range is essential for treatment of IDDM. In DM patients undergoing major surgical procedures, being out of target range, a BG beyond 80-240 mg/dL, can cause hypoglycemia (low BG) or hyperglycemia (high BG) which leads to significant complications throughout the perioperative process. Before 2012, Cincinnati Children’s Hospital Medical Center (CCHMC) did not have a plan for IDDM patients undergoing surgery. Endocrinologists created a perioperative DM plan for the patient, nurses, anesthesiologists, and surgeons in order to decrease hypo- and hyperglycemia, operating room delays, and improve communication among the multidisciplinary team. Data collected from the electronic health record and surveys following CCHMC patients throughout the perioperative process indicate improvement in the perioperative process and reduced OR delays between 2012 and 2015. Data is now being used to provide the perioperative care team a better understanding of diabetes management in the perioperative process with plans to spread implementation nationwide.
