Mr. Q’s fasting glucose morning on the of surgery was 152mg/dL. His surgical team proceeded with his planned surgery after they started him on starting stress dose steroids followed by postop tapering dose as per his primary-care provider.

The patient’s intraoperative course was uneventful. He resumed his outpatient dose of insulin glargine the night of surgery.

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Postoperative fasting glucose levels ranged from 140 mg/dL mg to 156 mg/dL and postprandial levels from 256 mg/dL to 302mg/dL, leading to initiation of prandial aspart insulin and further increase in insulin glargine dose.

Hyperglycemic agents were titrated as per glycemic trend and Mr. Q eventually went back on his full outpatient regimen two days after restarting usual maintenance steroid dose.