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Less Is More
June 2014

More Can Be Life Threatening

Author Affiliations
  • 1Diabetes Center, Mamaroneck, New York
JAMA Intern Med. 2014;174(6):858. doi:10.1001/jamainternmed.2014.1229

I have had type 1 diabetes for 67 years and have enjoyed essentially normal blood glucose levels since the availability of the first blood glucose meter in 1969. As a result I do not have the premorbid conditions frequently associated with diabetic patients who undergo surgery. Nevertheless, on entering a hospital I am at great risk for iatrogenic hypoglycemia and ketoacidosis (DKA).

About 2 years ago I was scheduled for a minor, 2-hour surgical procedure while under general anesthesia. The hospital was a world-famous institution associated with a major federally funded diabetes center. I had given my surgeon detailed printed instructions for maintenance of my blood glucose level during the perioperative period. He agreed with them and promised they would be followed.

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