Patients with insulin

Patients with insulin-dependent diabetes and non–insulin-dependent diabetes require special consideration when presenting for surgery. Geriatricage patients come to the OR in the fasting state and without having taken their morning dose of their oral diabetic agent. Chlorpropamide is the longest-acting sulfonylurea and has a duration of action up to 72 hours. Accordingly, it is prudent to measure serum glucose before inducing anesthesia and periodically during the course of the anesthetic and surgery.Regular insulin has a peak effect 2 to 3 hours after SQ administration and a duration of action approximately 6 to 8 hours and would therefore not cause a serum glucose of 35 mg/dL 24 hours after it was administered