Antidiabetic drugs: What the anesthesiologist should know

Therapeutic and technological evolutions have been major in diabetes over the last decade and have dramatically changed therapeutic strategies and management pathways of patients with type 1 diabetes (T1D) or type 2 diabetes (T2D). New therapeutic classes (GLP-1 receptor agonists and SGLT2 inhibitors) have demonstrated cardio-renal protection benefits, challenging the classical glucocentric therapeutic strategy of type 2 diabetes. New insulins with improved pharmacokinetics are now available. Continuous glucose monitoring is now widely available in T1D and T2D insulin treated patients and has led to the emergence of new parameters for metabolic control assessment. Finally, automated insulin delivery systems (closed-loop systems) are a major advance in the treatment of T1D and will soon arrive in T2D. These new approaches have limitations and risks that must be known by anesthesiologists who daily manage many patients with diabetes.t