Basal insulin / NPH / insulin pumps
Insulin requires an individual perioperative plan. Type 1 diabetes requires ongoing basal insulin coverage even during fasting. A blanket instruction to stop all insulin is unsafe.
The perioperative plan needs to address the regimen, dose timing, monitoring and correction of glucose levels before surgery. Basal analogues, NPH, mixed insulin and pumps require different approaches. Renal impairment, previous hypoglycaemia, usual dose, fasting duration and procedure timing affect the plan.
Pump continuation depends on the procedure and institutional support. When a pump cannot continue, alternative insulin delivery is needed before interruption. The full ADA perioperative guidance and institutional protocol provide the context for regimen-specific adjustments; this short reference is not a dosing chart.