Correction to: Peri-operative management of the surgical patient with diabetes 2015: Association of Anaesthetists of Great Britain and Ireland (Anaesthesia, (2015), 70, 12, (1427-1440), 10.1111/anae.13233)

Abstract

Following a letter published in the correspondence website of this journal, and new evidence emerging about the risk of ketoacidosis during periods of starvation in patients taking sodium-glucose co-transporter-2 (SGLT-2) inhibitors, the authors of the Association of Anaesthetists guideline ‘Peri-operative management of the surgical patient with diabetes 2015’ would like to update the guidance regarding the peri-operative adjustment of these oral hypoglycaemic agents. The updated version of Table is below. Guideline for peri-operative adjustment of oral hypoglycaemic agents (short starvation period – no more than one missed meal) (Table presented.) § If there is likely to be a period of reduction in oral intake before a procedure (for example colonoscopy), then the drug needs to be omitted starting on the day of the reduced intake. This may mean omitting the drug the day before the procedure, as well as the day of the procedure. If the patient is likely to have a low carbohydrate diet for several weeks (for example before bariatric surgery) then the drug should be stopped from the commencement of the diet. * If contrast medium is to be used or the eGFR is < 60 ml min−1 1.73 m−2, metformin should be omitted on the day of the procedure and for the following 48 hr. SGLT-2, sodium-glucose cotransporter-2; DDP-IV, dipeptidyl-peptidase IV; GLP-1, glucagon-like peptide-1; VRIII, variable rate intravenous insulin infusion; NBM, nil by mouth.