In what scenario should sulfonylureas be temporarily discontinued?

Sulfonylureas should be temporarily discontinued during surgery. This is primarily due to the potential stress-induced hyperglycemia that can occur during surgical procedures. When a patient undergoes surgery, their body may require a different management strategy for blood glucose levels due to factors like fasting, hormonal changes, and variations in diet and activity levels.

Continuing the use of sulfonylureas during this time could pose a risk for hypoglycemia, especially if the patient is unable to eat or drink and then does not have sufficient endogenous glucose production in response to the stress of surgery. Therefore, healthcare providers often recommend holding sulfonylureas during surgical procedures to avoid complications related to glucose metabolism.

In addition, a thorough monitoring strategy is typically implemented during surgery for glucose levels, and, if necessary, alternative management approaches such as the use of intravenous insulin or adjusting ongoing diabetes medications will be considered to maintain stable blood glucose levels while ensuring the patient’s safety.