Patients with type 2 diabetes are commonly referred for elective or emergency surgery. In case of scheduled surgical procedures, previous guidelines recommended to withhold oral glucose-lowering drugs.

Based on recent literature, this tendency has shifted toward treatment continuation.

In most cases, the continuation of glucose-lowering drugs seems safe, although it may be recommended to temporarily interrupt treatment, e.g., on the day of surgery, when there is fasting, reduced food intake, or risk of renal dysfunction.

Inadvertent discontinuation may worsen glycemic control and increase complication rates, whereas an inappropriate continuation of sulfonylurea or sodium glucose cotransporter-2 inhibitors may induce hypoglycemia or ketoacidosis.

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