2020 Volume 41 Issue 4 Pages 347-352
Type 1 diabetes (IDDM) is a disease in which β cells of the pancreatic islets of Langerhans are destroyed by autoimmune deficiency, resulting in an absolute insulin deficiency. Its incidence in children is 1.5-2 per 100,000 annually. A problem of its perioperative management is the difficulty of managing blood glucose levels due to their extensive fluctuations. Herein we report the perioperative management of a type 1 diabetes child with mental retardation. The patient was an 11-year-old girl, who was diagnosed with IDDM based on HbA1c of 12.7% and blood glucose of 343 mg/dl, and was undergoing intensive insulin therapy.
Because she had dysarthria, we planned pharyngeal valvuloplasty under general anesthesia. Before the surgery, glycemic control was performed in our hospital in close cooperation with a diabetic specialist. During the operation, the patient received an infusion containing glucose and potassium, and continuous administration of short-acting insulin. Blood glucose and electrolytes were as necessary and controlled appropriately. She had a hypoglycemic seizure postoperatively but could be well managed without any serious complication.
