1. Diabetes Mellitus in a pre- operative patient: associated risks and complications of general anesthesia Julie L Williams M.D., M.S. CA-1

2. Assessing severity of DM Gold standard: HemoglobinA1c Goals of <5.5-6% Often a recent HbA1c is not available... Evaluate patient in pre-operative clinic setting with basic metabolic panel, accucheck, repeat blood glucose test on morning of surgery. Body Habitus Type 1 vs. Type 2 Pharmacologic management

3. Specific pre-operative concerns D.M., no matter how well or poorly controlled is a risk factor for CAD and major cardiac event in perioperative setting. Pre operative testing EKG CMP fasting and post prandial blood glucose Urinalysis CBC

5. ASA/ACA guidlines