 Nu, we zien dat het heel speelig in diegde praktie is om diegde patiën te zien, maar waarom is het zo belangrijk om diegde te identifieer? Wel, meneer van diegde moet genoemd behoorlingen door vascula effectie. Die hebben micro-vascula problemen. Die effectie is die brainen, die coronarys met carnaval problemen, en speciaally die kidneys, nie om die periferies te mention. Die ook die geluidschiften, die osmotic diaresis met glukos, die ook elektrolyde schiften, om diegde patiën te zien, met glukos die patiën intercellen. Waarschijnlijk is het heel belangrijk, risiek voor hypoglycemia. Waarschijnlijk is het heel belangrijk om diegde patiën te zien, of niet genoem glukos, die perioperatieve baats van hypoglycemia, ook hypoglycemia, als hun controle is nie diegde, met acidoses, schok, etc. Deze patiën hebben immunodeficitie. Die hebben polymorphonucleosel en normale. Die doen nie die geluidschiften, opropele, in die weregen die er nodig zijn, die hebben hygocytic probleem, ook. Dat moet ongehoog met diegde patiën, septic complications, woonsepsis, etc. Die hebben diegde healing rates, en dat moet ongehoog, als u aastemoses doen. Die hebben ongehoog rate van morbidity en mortality. Hoe doen we diegde patiën diegde? First of all, they'll be the subset that come in and tell you, I have diabetes. It's important to find out what type they have, how long they've had it, what medication they are on, and what comorbid problems they do suffer from. Some won't know that they have diabetes, so at risk of developing diabetes. For these, you really have to take a careful history and a physical examination as you do with all patients. Some institutions as patients come in for the first time, for first consultation they might get your analysis and you might pick that up on the dip sticks. It's important to listen out for the following things. Polyuria, that's where they urinate a lot. Polydipsia, where they thirst you all the time and want to drink a lot. And weight loss, these might be indicative of type 1 diabetes. And always be careful, of course, if overweight patients they are at high risk for suffering type 2 diabetes. There are general known risk factors, such as age, 6 family histories and problems with exercise levels. And these have even been built into an online calculator as we had with the cardiac situation and you can see it there at bit.ly that's a 1, a lower case 0, an uppercase jz, a 0, a g and an uppercase i and you can see an online calculator that you can use. Watch out for the patient who comes for vascular surgery. Up to 20% of them will be diabetics. Watch out for the patients on high dose corticosteroids. Up to 50% of them will have post operative bounce of abnormal glucose levels. Now, once these patients are suspected of being diabetic you can send them for fasting glucose levels if there is abnormality they can have a proper glucose tolerance test. It is not recommended to send diabetics for HPA1C levels they are going to give you some estimate as to how good the control has been but it's not really going to alter your surgical management of these patients. Now, once a diabetic has been diagnosed or you see a patient coming for surgery who is a diabetic there is a suggestion that this is your chance to examine at least their hearts and their kidneys. So it's not always feasible but consider sending these patients at least for stress ECG to look at their coronaries and to do renal function tests on them. We want to know the blood urea nitrogen or the urea and creatinine and especially the electrolytes.