Publication Details
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder affecting millions worldwide, characterized by insulin resistance, hyperglycemia, and multiple systemic complications. Surgical interventions in patients with T2DM are often complex due to increased perioperative risks, including delayed wound healing, higher infection rates, and comorbid conditions such as obesity, hypertension, and cardiovascular disease. Selecting the optimal surgical tactic is essential to minimize morbidity and enhance postoperative recovery. This review evaluates current evidence regarding surgical approaches in T2DM patients, focusing on preoperative assessment, risk stratification, intraoperative management, and postoperative care. The article highlights the benefits of minimally invasive surgery, enhanced recovery protocols, and multidisciplinary care. Evidence-based strategies to improve glycemic control, reduce cardiovascular risk, and manage perioperative complications are discussed. The findings aim to guide clinicians in selecting individualized surgical tactics to optimize outcomes in this high-risk population. Type 2 diabetes mellitus (T2DM) is a prevalent chronic metabolic disorder that poses significant challenges in surgical practice due to complex pathophysiological changes, including impaired glucose metabolism, microvascular and macrovascular complications, and altered immune function. Surgical interventions in this population are frequently associated with increased perioperative risk, including delayed tissue repair, higher susceptibility to infections, cardiovascular instability, and prolonged hospital stay. The selection of appropriate surgical strategies requires comprehensive evaluation of patient-specific characteristics, including age, comorbidities, nutritional status, and glycemic history, as well as careful consideration of the type and extent of the planned procedure. This article provides an in-depth analysis of contemporary surgical management for patients with T2DM, emphasizing the importance of preoperative optimization, intraoperative vigilance, and postoperative monitoring to enhance clinical outcomes. Evidence indicates that minimally invasive procedures, when feasible, are linked to reduced operative stress, faster recovery, and lower complication rates compared with traditional open surgery. Furthermore, multidisciplinary collaboration involving endocrinologists, anesthesiologists, and surgeons is critical in addressing the multifactorial risks inherent to this patient group. The review also examines perioperative protocols for maintaining stable glycemic levels, managing cardiovascular and renal risks, and implementing enhanced recovery strategies to support early mobilization and functional restoration. Findings from current literature and clinical guidelines are synthesized to provide evidence-based recommendations, guiding healthcare professionals in tailoring surgical tactics for optimal safety and efficacy. The insights presented aim to inform both clinical practice and future research, promoting standardized approaches that improve patient-centered outcomes in surgical interventions for type 2 diabetes.