f63fa27a_ving_Orthopaedic_Surgery___HSS__Reminders
[Category] Endocrine [Medications] Diabetes: Stop oral hypoglycemics 1 day surgery; discontinue chlorpropamide and glyburide 3 days before surgery For insulin users, ½ usual insulin dose before surgery with dextrose and water and sliding scale insulin; for prolonged NPO or brittle diabetes, insulin drip. Thyroid Disease: Continue thyroid supplements through surgery Reduce L-thyroxine dose by 20% for long-term parenteral use Corticosteroids: Stress doses if used regularly within a year of surgery, tapering over 3-4 days to maintenance after surgery. [Reminders] 
Even young diabetic patients have autonomic insufficiency. Prolonged anesthetic effect after surgery may suggest hypothyroidism
Perioperative Medical Care of Rheumatic Disease Patients Having Orthopaedic Surgery - HSS
Reminders