Type 1 diabetes mellitus - Perioperative management of children and adolescents

Patients with type 1 diabetes require continuous substitution of exogenous insulin due to their disability to produce insulin themselves. The insulin dosage required is individual-specific and may change dramatically during the perioperative period. The patient may be endangered by metabolic decompensation including hypoglycaemia and diabetic ketoacidosis. Thus, perioperative management should include frequent blood glucose measurements and frequent adjustment of the insulin and glucose administration. When planning the operation, an individual treatment regime should be drawn up and be made available to the medical team. In order to facilitate the challenging perioperative management of these patients, this article presents the current recommendations for the perioperative management of children and adolescents with type 1 diabetes mellitus (i.e. of the International Society for Pediatric and Adolescent Diabetes, ISPAD).