search

CAS SAMBA Ambulatory Anesthesia Collaborative Rounds Series - Diabetic Management in Ambulatory Surgical Patients

March 12, 2025

8:00 pm - 9:30 pm

The second round in the CAS SAMBA Ambulatory Anesthesia Collaborative Rounds Series will focus on the updated North American guidelines for perioperative blood glucose management in ambulatory surgery patients with diabetes.

The Society for Ambulatory Anesthesia has recently updated its consensus statement regarding the management of blood glucose in patients with diabetes mellitus undergoing ambulatory surgery; this 2024 update replaces the 2010 guidelines. Similarly, the Canadian Standards for Perioperative/ Periprocedure Glycemic Management Expert Consensus Panel has recently updated its consensus guidelines regarding the perioperative management of patients with Type I and Type II Diabetes; the 2025 update replaces the Canadian 2021 recommendations. 

Recent advancements in diabetes management, particularly the introduction of new hypoglycemic agents, insulin pumps, and continuous glucose monitors are reflected in the updates to both the Canadian and American guidelines. These updates are critical for optimizing the perioperative care of the increasing number of diabetic patients. Join the authors of both the new American and Canadian guidelines as we review, compare and contrast the Canadian and American evidence-based recommendations.

After attending this round, the participants will be able to: 

  1. Discuss the newly recommended BG targets in ambulatory surgery (versus inpatient goals) 
  2. Assess current literature outlining risks and benefits of oral hypoglycemic use in the perioperative period. 
  3. Describe safe and effective practices to dose home insulin prior to ambulatory surgery. 
  4. Outline current data examining pre-operative carbohydrates in DM2
  5. Identify relevant consideration for the use of GLP-1RAs and diabetes devices 

 

To learn more about the topic, we recommend the following readings: 

1. Goldenberg, R. M., Gilbert, J. D., Houlden, R. L., Khan, T. S., Makhija, S., Mazer, C. D., … Verma, S. (2025). Perioperative and periprocedural management of GLP-1 receptor-based agonists and SGLT2 inhibitors: narrative review and the STOP-GAP and STOP DKA-2 algorithms. Current Medical Research and Opinion, 1–17. https://doi.org/10.1080/03007995.2025.2458538

2. Houlden RL, Gilbert JD, Khan TS, Mazer CD, Trinacty J, Verma S, Goldenberg RM. Perioperative and periprocedural management of once-weekly insulin treated patients. Endocrine Practice. 2025 Jan 28:S1530-891X(25)00033-3. doi: 10.1016/j.eprac.2025.01.009. Epub ahead of print. PMID: 39884510.

3. Rajan R, Duggan EW (Co-First Authors), Abdelmalek B, Butz S, Rodriguez LV, Vann MA, Joshi GP. Society for Ambulatory Anesthesia (SAMBA) updated consensus statement on perioperative blood glucose management in adult patients with diabetes mellitus undergoing ambulatory surgery. Anesthesia & Analgesia. 2024. 139(3): 459-477. doi: 10.1213/ANE.0000000000006791.https://pubmed.ncbi.nlm.nih.gov/38517760/