Perioperative Management of Comorbidities

A 58-year-old man with a 10-year history of type 2 diabetes mellitus (HbA1c 8.2%) and hypertension (on amlodipine 5 mg daily) presents for elective laparoscopic cholecystectomy. His fasting blood glucose is 156 mg/dL. On examination, BP is 138/88 mmHg, HR 82/min, and BMI 28 kg/m². ECG shows normal sinus rhythm with no ST changes. He denies chest pain, dyspnea, or orthopnea. What is the most appropriate perioperative glucose management strategy for this patient?

A 62-year-old woman with a 15-year history of hypertension (on enalapril 10 mg daily and amlodipine 5 mg daily) and chronic kidney disease stage 3b (eGFR 38 mL/min/1.73m²) presents for elective open abdominal hysterectomy. Preoperative BP is 146/92 mmHg, HR 88/min, and serum creatinine is 1.8 mg/dL (baseline 1.6 mg/dL). She denies dyspnea or chest pain. What is the most appropriate perioperative antihypertensive management for this patient?

Which of the following antidiabetic medications should be held on the morning of surgery to minimize the risk of intraoperative hypoglycemia?