# Perioperative screening and management of hyperglycemia: a joint position statement from the Brazilian Diabetes Society (SBD), the Brazilian Society of Anesthesiology (SBA) and the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO)

## TL;DR

This paper provides guidelines for managing high blood sugar before, during, and after surgery to reduce complications and improve patient outcomes.

## Contribution

A joint position statement offering 19 recommendations for perioperative hyperglycemia management based on expert consensus and evidence review.

## Key findings

- Hyperglycemia in hospitalized patients increases postoperative complications and mortality.
- The guidelines include strategies for screening, glycemic targets, and insulin management.
- Recommendations aim to improve surgical outcomes through effective glycemic control.

## Abstract

Hospital hyperglycemia, whether or not diabetes has been previously diagnosed, increases the risk of postoperative complications, particularly infections, prolonged hospital stay, and in-hospital mortality. Ensuring adequate glycemic control during the perioperative period helps reduce these risks and improve surgical outcomes.

This guideline was developed by the Department of Acute Complications and Inpatient Glycemic Control of the Brazilian Diabetes Society (SBD), in collaboration with representatives from the Brazilian Society of Anesthesiology (SBA), the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), and the SBD Scientific Committee. Key clinical questions guided a narrative review of the literature using MEDLINE via PubMed, including evidence from randomized clinical trials (RCTs), meta-analyses, and high-quality observational studies.

The expert group produced 19 recommendations and 20 key notes addressing screening, glycemic targets, management of oral and injectable agents, insulin strategies, and prevention of perioperative complications. Based on the best available evidence, this joint statement provides practical and effective guidance for managing perioperative hyperglycemia across different levels of healthcare.