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Correction: surgery and insulin-dependent diabetes (September 24, 1984, p.74)


We said ‘for minor elective surgery the insulin can be withheld on the day of the operation until the patient can eat’. This is true for a short minor operation performed early in the morning, but, as a correspondent has pointed out, a patient without endogenous insulin or with only brittle control whose operation happens to get delayed could quietly slip into ketoacidosis. If such a delay is likely the patient should be given an intravenous infusion of insulin and glucose as outlined for major surgery. A common regimen is to add 8 – 16 units of soluble insulin to one litre of 5% dextrose to be infused over 8 hours.

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