So, the idea for this thread comes from the recent board question on subarachnoid bleed and insulin.

Within the last couple of years, the once sexy ICU/periop management goal of a glucose between 80 and about 120 has been all but abandoned. Anyone with any experience in trying to do that can give many reasons as to just why we don't do that anymore.

The question is, what do you do now? What is your treat/don't treat threshold for blood sugar intraop? And how do you treat? Bolus? Infusion? Both? Do you wait until PACU? Why?

This is not a 'at what glucose do you postpone the case' question. It's a periop glucose management question.