Preoperative Insulin Intensification to Improve Day of Surgery Blood Glucose Control.

Preoperative insulin intensification the evening before surgery did not change rates of DOS hyperglycemia or hypoglycemia. HCP adherence decreased transiently, which briefly increased DOS hyperglycemia rates in some patients. Perioperative hyperglycemia, defined as blood glucose levels ≥ 180 mg/dL in the immediate pre- and postoperative period, is associated with increased postoperative morbidity, including infections, preoperative interventions, and in-hospital mortality.1-3 Despite being identified as a barrier to optimal perioperative glycemic control, limited evidence is available on patient or health care practitioner (HCP) adherence to preoperative insulin protocols.4-6.