ROYAL COLLEGE MANUAL For management of DM in Surgical patients
conditions FBS 2HA 75gm glucose
DM ≥7 mmol/lit ≥11.1

IGT <7 ≥7.8 - ≤11.1 IFG ≥6.1 - <7.8 <7 Normal <6.1 <7.8 Indication of Insulin : if FBS ≥ 16.7 BMI -≥ 25sq m/Kg < 11.1- lifestyle change >11.1- <16.7 -OHA >16.7 -Insulin

Chance of wound infection:if FBS>11.1

FBS RBS remark
Gn medical cond/Surgery 90-126mg/dl <200 Low inf rate Cardiac surgery <150 <150 Low sternal infection Acute Neurological disorder 80-140 Type Minor surgery Major surgery

Pt on oral diet no precaution monitor 4hrly
if>12mmol/lit start GKI

Pt on oral agent omit on morning omit
start when pt on oral monitor 2hrly
if>12mmol/lit start GKI

Pt on insulin stop insulin when pt on NPO start GKI