New Insulin Analogues and Perioperative Care of Patients with Type 1 Diabetes (Report‪)‬

In 2000, Hopkins and Hunter wrote in an editorial that "Every trained anaesthetist should be able to manage patients competently with any form of diabetes ..." but that "Perioperative management of diabetic patients is often suboptimal: this is inexcusable. ..." (1). Managing patients with type 1 diabetes has changed over the last 15 years, particularly during the first years of the new century, with greater understanding of the importance of blood glucose control and advances in insulin pharmacology, delivery systems and monitoring devices (2,3). Over the same period there have been marked changes in anaesthesia and surgery often with day-of-surgery admission. We review changes in managing type 1 diabetes and how these changes may affect the perioperative period. TYPE 1 DIABETES