. Author manuscript; available in PMC: 2018 Mar 1.

Published in final edited form as: Anesthesiology. 2017 Mar;126(3):547–560. doi: 10.1097/ALN.0000000000001515

Table 1.

Society Guidelines Recommendations for Treatment of Perioperative Hyperglycemia and Diabetes

	Ambulatory Surgery	ICU	Non-ICU
SAMBA ⁴⁸	SC rapid-acting insulin analogs are preferred over IV or SC regular insulin *Treatment goal:* Intraoperative blood glucose levels <180 mg/dL (10 mmol/L)
ADA/AACE ⁴⁹		Initiate insulin therapy for glucose >180 mg/dL (10 mmol/L). *Treatment goal:* For most patients, target a glucose level between 140–180 mg/dL (7.7-10 mmol/L). Glucose target between 110–140 mg/dL (6.1-7.7mmol/L) may be appropriate for select patients, if achievable without significant risk for hypoglycemia.	*Treatment goal:* If treated with insulin, pre-meal glucose targets should generally be <140 mg/dL (<7.7 mmol/L), with random glucose levels <180 mg/dL (10 mmol/L).
ACP ⁵²		Recommends against intensive insulin therapy in patients with or without diabetes in surgical/medical ICUs. *Treatment goal:* Target glucose is between 140-200 mg/dL (7.7-11.1mmol/L) in patients with or without diabetes.
Critical Care Society ⁵⁰		BG >150 mg/dL (8.3 mmol/L) should trigger insulin therapy. *Treatment goal:* Maintain glucose <150 mg/dL (8.3 mmol/L) for most patients in ICU.
Endocrine Society ³⁰			*Treatment goal:* Target premeal blood glucose <140 mg/dL (7.7 mmol/L) and random glucose <180 mg/dL (10 mmol/L). Higher target glucose <200 mg/dL (11.1 mmol/l) is acceptable in patients with terminal illness and/or with limited life expectancy or at high risk for hypoglycemia.
Society of Thoracic Surgeons ⁵¹		Continuous insulin infusion preferred over SC or intermittent IV boluses. *Treatment goal:* Recommend glucose <180 mg/dL (10 mmol/L) during surgery, ≤110 mg/dL (6.1 mmol/L) in fasting and pre-meal states.
Joint British Diabetes Societies ⁵³			Initiate insulin therapy for glucose >10 mmol/L (180 mg/dL). Target blood glucose levels in most patients are between 6 and 10 mmol/L (108–180 mg/dL) with an acceptable range of between 4 and 12 mmol/L (72–216 mg/dL).

SAMBA: Society for Ambulatory Anesthesia; AACE/ADA: American Association of Endocrinologists and American Diabetes Association joint guidelines; ACP: American College of Physicians; ADA: American Diabetes Association; ICU: intensive care unit; IV: intravenous; SC: subcutaneous.