Hormones part 2: Insulin and other glucose-controlling medications

Diabetes mellitus (DM) is an extremely common disease process worldwide. Diabetic patients often need surgical interventions for a wide variety of reasons. One of the differences between type 1 and type 2 DM is that patients with type 1 would die without insulin and is associated with an autoimmune attack on the patient’s beta cells in the pancreas. Type II diabetes mellitus (T2DM) is characterized by insulin deficiency, insulin resistance, and increased hepatic glucose output. The chronic state of elevated glucose levels affects the whole body at a macro- and microvascular level, ultimately leading to the deterioration of vital organs, such as the kidney, cardiac, and nervous system. Diabetes is the leading cause of renal insufficiency in the United States and is a strong risk factor for coronary artery disease. This chronic state affects many perioperative patients currently, and its prevalence is projected to increase substantially in the near future.