Anest. intenziv. Med. 2024;35(3):162-167 | DOI: 10.36290/aim.2024.021

Perioperative management in patients treated with gliflozinsReview Article

©itina M.1-3, ©rámek V.1
1 Anesteziologicko­‑resuscitační klinika, FN u sv. Anny, Brno
2 Oddělení Biostatistiky, International Clinical Research Center, FN u sv. Anny, Brno
3 Ústav patologické fyziologie, Lékařská fakulta, Masarykova univerzita, Brno

Patients treated with gliflozins, mostly with type 2 diabetes mellitus, may develop ketoacidosis with normal to moderately eleva­ted glycemia (euglycemic ketoacidosis) in the perioperative period. Therefore, gliflozins should be discontinued 3-4 days before elective surgery and only restarted when oral intake is reliably restored and the condition is clinically stable. In the case of minor surgery without the need for fasting, omitting gliflozins only the day before surgery and on the day of surgery may be considered. If gliflozins have not been discontinued, acid-base balance and, optimally, ketone bodies should be checked regularly until reliable resumption of oral intake. When ketoacidosis is detected, immediate treatment with intravenous insulin is required until ketone bodies disappear.

Keywords: perioperative management, euglycemic ketoacidosis, diabetes mellitus, gliflozins, SGLT2 inhibitors.

Received: January 23, 2024; Revised: May 2, 2024; Accepted: May 6, 2024; Prepublished online: June 18, 2024; Published: October 7, 2024  Show citation

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©itina M, ©rámek V. Perioperative management in patients treated with gliflozins. Anest. intenziv. Med. 2024;35(3):162-167. doi: 10.36290/aim.2024.021.
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