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Insulin Pump Perioperative Management — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModerateDay SurgeryInsulin Pump Perioperative ManagementFRCA Final

A 40-year-old man is scheduled for ambulatory shoulder arthroscopy. He has well-controlled type 1 diabetes on an insulin pump (continuous subcutaneous insulin infusion). According to JBDS guidelines, how should his insulin pump be managed for this short day-case procedure?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Continue the pump at basal rate throughout

JBDS (2022) guidelines recommend that patients with insulin pumps should continue their pump at the basal rate during short procedures where the starvation period is expected to be brief (one missed meal). The patient should be first on the morning list. Blood glucose should be monitored hourly. Only if the fasting period exceeds one meal or the glucose becomes difficult to manage should a variable rate insulin infusion (VRIII/sliding scale) be considered. The pump should never simply be disconnected without an alternative insulin source.

Reference: JBDS – 2022 – Management of adults with diabetes undergoing surgery; CPOC – 2021 – Perioperative diabetes