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Overview :
Most patients with diabetes mellitus can safely undergo
ambulatory surgery with rapid discharge. The presence of certain complications
or social factors may require the patient to be admitted before or after
ambulatory procedures.
Reasons to consider admitting a diabetic patient:
(1) unable to adequately evaluate the patient prior to
surgery
(2) end-organ disease requires invasive monitoring
(3) requires careful prehydration
(4) evidence of CNS ischemia
(5) pregnant
(6) blood
glucose level cannot be monitored after the discharge by the patient or a
responsible person in the home environment
(7) body
temperature cannot be monitored after the discharge by the patient or a
responsible person in the home environment
(8) wound
status cannot be monitored after the discharge by the patient or a responsible
person in the home environment
(9)
unsuitable social support network or unable to return for medical evaluation in
the event of a problem
(10)
presence of significant autonomic neuropathy
(11)
problems maintaining adequate glucose control (either hyper- or
hypoglycemia)
where:
• The table
also listed "cardiopulmonary bypass" as a criterion for admission. I am unaware
of an ambulatory surgical procedure for which this is required.
• I changed "invasive monitoring" to "intensive monitoring"
in the implementation.
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