Management of the patient with diabetes in the perioperative period.

With the ever-increasing number of patients with diabetes undergoing surgical procedures, effective perioperative management of diabetes mellitus has become progressively more important. In this review we discuss a number of strategic approaches to improve perioperative management, where the fine balance between aggressive blood glucose management and prevention of hypoglycaemia must be considered. We also discuss complications of diabetes mellitus, particularly where these directly compromise patient health and interventional outcomes.

Psychosocial considerations of perioperative care in children, with a focus on effective management strategies.

Children are not just 'small adults'. They have specific physical, psychological and social requirements that must be identified and addressed to optimise their well-being in the perioperative period. The healthcare practitioner should be trained to understand the needs of the paediatric patient in hospital, including the ever increasing need to take into account cultural differences. Hospital policy should include a preoperative preparation programme, specially aimed at the paediatric population, where parental involvement is encouraged throughout.