What is the recommended intraoperative perioperative glucose target for diabetic patients?

• A. Maintain blood glucose around 70-110 mg/dL.
• B. Maintain blood glucose around 180-200 mg/dL.
• C. No glucose monitoring is required during surgery.
• D. Maintain blood glucose roughly 140–180 mg/dL intraoperatively.

Answer: (D)

Maintaining blood glucose within a moderate range during the operation helps prevent the harms associated with both too much and too little glucose when anesthesia is in use and the body’s stress response is active. In diabetics, the goal is to avoid hyperglycemia that can impair immune function and wound healing, while also avoiding hypoglycemia that anesthesia and perioperative factors can mask. The target of about 140–180 mg/dL strikes the best balance, supported by guidelines and perioperative studies showing better outcomes with this range compared to tighter control or allowing levels to drift higher. Keeping glucose around 70–110 mg/dL is too restrictive for most surgical patients and increases hypoglycemia risk, while 180–200 mg/dL is associated with worse outcomes due to sustained hyperglycemia. Glucose monitoring is essential during surgery to maintain this range.