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.
