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LETTER TO THE EDITOR

Thinking Like A Pancreas: A Look Ahead at Diabetes Technology in the Perioperative Setting

Departments of Anesthesiology and Critical Care Medicine and Surgery; Johns Hopkins University School of Medicine; Baltimore, MD; emartine{at}jhmi.edu

In Response:

Commenting on our recent editorial (1), Torjman et al. (2) suggest the possibilities for new technologies in blood glucose monitoring. We agree that the current methodology for frequent blood glucose monitoring during tight glycemic control is burdensome, and a new system may improve our efficiency with continuous blood glucose monitoring. While we look forward to new technology and how it may improve patient care, we need to recognize that new technology introduces a new set of risks (3). We hope that the use and impact of new technologies for continuous blood glucose monitoring will be comprehensively evaluated and will result in improved patient outcomes. Of course, there are unanswered questions on the safety and efficacy of "tight" glycemic control in all perioperative settings (4). In addition, future questions addressing whether continuous monitoring and more frequent interventions improve the safety and effectiveness of glycemic control will likely arise.

REFERENCES

1. Martinez EA, Williams KA, Pronovost PJ. Thinking like a pancreas: perioperative glycemic control. Anesth Analg 2007; 104:4–6[Free Full Text]
2. Torjman ML, Michael EG, Robert AH, Jeffrey L. Thinking like a pancreas: a look ahead at diabetes technology in the perioperative setting. Anesth Analg 2007;105:545[Free Full Text]
3. Weant KA, Cook AM, Armitstead JA. Medication-error reporting and pharmacy resident experience during implementation of computerized prescriber order entry. Am J Health Syst Pharm 2007;64:526–30[Abstract/Free Full Text]
4. Gandhi GY, Nuttall GA, Abel MD, Mullany CJ, Schaff HV, O’Brien PC, Johnson MG, Williams AR, Cutshall SM, Mundy LM, Rizza RA, McMahon MM. Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial. Ann Intern Med 2007;146:233–43[Abstract/Free Full Text]

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