Diabetes: a continuous challenge for anesthesiologist

Diabete Mellitus is not a simple metabolic disoorder but a worldwide emergent problem that has its implications both in patients in the intensive care unit and in the perioperative period. Preoperative evaluation, management and treatment of perioperative hyperglycemia is still an open question for anesthesiologists. Evaluation of decreased functions of various organs and compromised systems by diabetic pathology are mandatory, especially cardiac and renal function, muscoloskeletal impairment related to predictive difficult intubation. A strict control of glycemia in order to reduce complications and reduce the incidence of wound infection is mandatory but an algorithm of the best insulin infusion unanimously shared is not reported. However the key of perioperative treatment is an intensive control of glycemic value to avoid extreme hyperglicemia but above all hypoglycemia