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<p>Automated insulin therapy (AID) is the standard treatment for children and adolescents with type&#xa0;1 diabetes in Germany. AID systems are capable of responding to glycemic changes by adjusting insulin delivery. This also applies to potential intraoperative changes in glucose levels. However, an AID system must be operated by trained personnel, which is not usually the case for operating room staff. Nevertheless, there are also young patients without AID therapy, so an adequate replacement, e.g., for intensive insulin therapy, must be ensured. Therefore, clinics must develop a&#xa0;concept for how peri- and intraoperative management can be carried out safely and in accordance with the medical device operating laws and directives, preferably in the form of internal standard operating procedures (SOPs) that are known to the teams concerned. Children and adolescents with type&#xa0;2 diabetes and/or obesity may also be treated with metformin, other oral antidiabetic drugs, or glucagon-like peptide1 (GLP1-RA)-receptor agonists. Therefore the same caution regarding fasting and the potential preoperative discontinuation of therapy applies as for adults. However the discontinuation of chronic insulin substitution especially in people with type&#xa0;1 diabetes is absolutely contraindicated.</p>

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Perioperatives Management von Menschen mit Diabetes mellitus: Pädiatrie

  • 期刊论文

  • 发表日期：

    2026年3月19日

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  • Torben Biester,
  • Thomas Kapellen

摘要

Automated insulin therapy (AID) is the standard treatment for children and adolescents with type 1 diabetes in Germany. AID systems are capable of responding to glycemic changes by adjusting insulin delivery. This also applies to potential intraoperative changes in glucose levels. However, an AID system must be operated by trained personnel, which is not usually the case for operating room staff. Nevertheless, there are also young patients without AID therapy, so an adequate replacement, e.g., for intensive insulin therapy, must be ensured. Therefore, clinics must develop a concept for how peri- and intraoperative management can be carried out safely and in accordance with the medical device operating laws and directives, preferably in the form of internal standard operating procedures (SOPs) that are known to the teams concerned. Children and adolescents with type 2 diabetes and/or obesity may also be treated with metformin, other oral antidiabetic drugs, or glucagon-like peptide1 (GLP1-RA)-receptor agonists. Therefore the same caution regarding fasting and the potential preoperative discontinuation of therapy applies as for adults. However the discontinuation of chronic insulin substitution especially in people with type 1 diabetes is absolutely contraindicated.