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The preoperative evaluation of a child with type I diabetes mellitus should<br />
include all of the following EXCEPT:<br />
<br />
a) Assessment at least 1 day prior to elective anesthesia to allow time to institute<br />
changes in therapy if needed<br />
<br />
b) Confirmation of the child’s insulin management regimen including insulin<br />
dose and blood glucose goals with the family and primary care doctor or<br />
endocrinologist<br />
<br />
c) Scheduling as the first case of the day to minimize NPO time<br />
<br />
d) Administration of the patient’s usual dose of long-acting insulin the night prior<br />
to surgery<br />
<br />
e) Discussion of whether the patient’s insulin pump should be continued during<br />
the case<br />
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==Answer==<br />
Answer a. All of the above are prudent for preoperative care of the child with<br />
Type I diabetes, except that diabetics should be assessed at least 10 days (not 1<br />
day) prior to elective anesthesia. Serum electrolytes are also an important part of<br />
the evaluations, and hemoglobin A1C assessment may provide information as to<br />
the child’s general state of diabetes control. Hemoglobin A1C assessment reflects<br />
chronic control (not any acute changes made prior to anesthesia) and is not a<br />
universally-required part of the evaluation process at all centers.<br />
==Notes==<br />
<references /><br />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.<br />
==Keywords==<br />
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