Problems in Diabetes Management Part I. The Diabetic needing Surgery and the Addington Protocol

Abstract

This is Part I of the Diabetes Management, and describes why the Addington Protocol was developed and what it is. Of the 1,2 million diabetics in the RSA, half of them will require surgery at least once in their lifetime, and there is no standard method which has been successful in regulating all the surgical diabetic - patients because both surgical procedures and patients' physical states, vary too much. Even the indispensable "sliding scale", which junior consultants carry with them as part of their survival-kit, is doomed to fail. This need for a more predictable, Logical and scientific method of maintaining glycaemic control in surgical patients (and in other diabetic complications) was identified, and met by the author, who developed this Addington Protocol to be used in the Addington Hospital in Durban. The protocol is explained, giving clear step-wise guidelines to the nursing staff, and looking at emergency surgery in diabetics. It concludes with the finding that, with adequate management during surgery, the mortality rate for patients with diabetes approximates that of the non-diabetic population.