Evidence map›Paper›PMID 41696887›Full record

ArticleAnaesthesia2026

Peri-operative management of diabetes mellitus: a multidisciplinary consensus statement from the Association of Anaesthetists and the Joint British Diabetes Societies for Inpatient Care group.

Nicholas A Levy, Kariem El-Boghdadly, Dileep N Lobo, Daniel J Stubbs, Parizad Avari, Donal Buggy, Claire Frank, Kim Howson, Jinty Moffett, Emma Morris and 10 more

Abstract readConsensus Statement
In one paragraph

Article in Anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Nicholas A LevyDepartment of Anaesthesia and Perioperative Medicine, West Suffolk NHS Foundation Trust, Bury St Edmunds, Suffolk, UK.ORCID 0000-0002-2225-1535
Kariem El-BoghdadlyDepartment of Anaesthesia and Perioperative Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.ORCID 0000-0002-9912-717X
Dileep N LoboNottingham Digestive Diseases Centre, Division of Translational Medical Sciences, School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK.ORCID 0000-0003-1187-5796
Daniel J StubbsNIHR Advanced Fellow Perioperative Acute Critical, and Emergency Care Section, University of Cambridge, Cambridge, UK.ORCID 0000-0003-2778-5226
Parizad AvariDepartment of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK.ORCID 0000-0001-9047-3589
Donal BuggyDepartment of Anaesthesia, Mater Misericordiae University Hospital, School of Medicine, University College Dublin, Dublin, Ireland.ORCID 0000-0003-3922-4397
Claire FrankWrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham, UK.ORCID 0009-0007-8197-792X
Kim HowsonJames Paget University Hospital NHS Foundation Trust, Great Yarmouth, UK.
Jinty MoffettPatient representative, Kingussie, UK.
Emma MorrisStockport NHS Foundation Trust, Stockport, UK.ORCID 0009-0009-2111-9848
Omar G MustafaDepartment of Diabetes, King's College Hospital, London, UK.ORCID 0000-0003-3123-809X
Glynn NashPatient representative, Teynham, UK.
Pádraig Ó ScanaillDepartment of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland.ORCID 0000-0001-8617-3372
Sarah ProcterDepartment of Anaesthesia, East Suffolk North Essex NHS Foundation Trust, Ipswich, UK.ORCID 0000-0003-3402-2980
Gerry RaymanDepartment of Diabetes, East Suffolk North Essex NHS Foundation Trust, Ipswich, UK.ORCID 0000-0003-3331-7015
Kim RussonDepartment of Anaesthesia, Rotherham NHS Foundation Trust, Rotherham, UK.ORCID 0000-0001-8042-3879
Caroline ThomasDepartment of Anaesthesia, St James University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.ORCID 0000-0002-9906-691X
Sarah TinsleyUniversity Hospitals of North Midlands, Stoke on Trent, UK.ORCID 0009-0007-5418-6225
Allan XuCore Trainee in Anaesthesia, London School of Anaesthesia, London, UK.ORCID 0000-0002-6190-2003
Ketan DhatariyaUniversity of East Anglia Medical School, Norwich, UK.ORCID 0000-0003-3619-9579

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSurgery in patients with diabetes mellitus is associated with increased morbidity and mortality compared with those who do not have diabetes mellitus. This is likely multifactorial and could be attributed to organisational issues; dysglycaemia; hospital-acquired diabetic ketoacidosis; errors with insulin prescribing and administration; issues with fluids and electrolytes; and systemic and surgical site infections. There was a need to update guidance for the peri-operative management of diabetes mellitus given improvements in our understanding, introduction of novel drugs and development of wearable technologies.

methodsThis was a multidisciplinary consensus statement with a diverse authorship group, including diabetologists; anaesthetists; surgeons; pharmacists; surgical diabetes inpatient specialist nurses; and patients with lived experience. We undertook a directed literature search and a three-round Delphi process to develop, refine and agree recommendations.

resultsFollowing three rounds, 38 recommendations were included, spanning all phases of the peri-operative pathway. Recommendations were made for organisations and general principles for the management of patients with diabetes, aiming to improve pathways, implement protocols and support training. We prioritise individualised care plans, encourage clinical judgement regarding proceeding with surgery with out-of-range HbA1c concentrations and recommend ensuring appropriate insulin regimens are prescribed and administered. We also provide guidance for capillary blood glucose and ketone monitoring and management; safe handovers of care; and multidisciplinary care plans for the peri-operative use of wearables. DISCUSSION: This consensus statement provides principles to be applied throughout the entire peri-operative pathway by healthcare professionals, institutions and patients. It is hoped that the implementation of these key recommendations will improve experience and outcomes for patients with diabetes mellitus having surgery.

Indexed as

Diabetes MellitusPerioperative CareAnesthetistsHumansHypoglycemic AgentsInpatientsInsulinSocieties, MedicalUnited KingdomHypoglycemic AgentsInsulindiabetes mellitusinsulinperi‐operativesafetysurgery

Identifiers

PMID41696887
PMCPMC13352544

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.