Diabetes Technology in the Perioperative Setting: A Primer for CRNA’s - CRNA Knowledge Network
Diabetes Technology in the Perioperative Setting: A Primer for CRNA’s
Continuous subcutaneous insulin infusion (CSII) via patient-owned insulin pump and blood glucose monitoring via continuous glucose monitor (CGM) are popular treatment modalities for people with diabetes, many who prefer that these treatments continue through the perioperative period. Devices such as insulin pumps and CGM’s are becoming more common with an estimated 30-40% of individuals with type I diabetes utilizing these new technologies in the home setting (Umpierrez & Klonoff, 2018). Since insulin pumps and continuous glucose monitors are not routinely seen in hospitals, many providers are not aware of their existence or proper use, making the transition to the surgical setting less than ideal (Umpierrez, 2018). Provider knowledge of diabetes technology is especially important in the perioperative period due to blood glucose variability and patient inability to perform self-care while under the influence of anesthetic medications. Since 2008, the Centers for Medicare and Medicaid Services, or CMS, included manifestations of poor glycemic management as a health care acquired condition, or HCAC (New York State Department of Health [NYSDOH], 2012which do not receive reimbursement or are reimbursed at a lesser rate by the Center for Medicare and Medicaid Services (CMS). Optimizing glycemic management in the perioperative period will decrease these occurrences, reducing reimbursement reductions. It is imperative that perioperative providers become familiar with the use of diabetes technology in order to care for patients that are wearing them during the perioperative period.
Gain increased understanding of rapidly evolving diabetes technology.
Shevy Serhofer, SRNA, RN, BSN, DNP-c
Shevy Serhofer is an SRNA at the University at Buffalo, with a special interest in diabetes management. While working at an academic medical center in NYC, she served on the diabetes champion committee, and her DNP project at UB focuses on diabetes technology, specifically in supporting the safe and effective use of patient-owned diabetes devices while in the hospital. Originally from Brooklyn, NY, Shevy is enjoying her time in Western NY and especially enjoys being close to Niagara Falls.