Day surgery and diabetes
Being admitted for Day Surgery?
Having to go to hospital for surgery or a procedure is often a stressful time. For people with diabetes, additional precautions need to be taken, particularly if taking medication for diabetes or insulin. Surgery, stress and changes in medication can, in the short-term result in blood glucose changes.
Planning for the Procedure
If possible, it is best to plan for the procedure but emergencies occur when little preparation time is available. You should ideally:
- Arrange a review of your diabetes management before the surgery with your diabetes specialist, General Practitioner and/or diabetes educator.
- Have your diabetes well controlled before the surgery as this will lessen the chance of complications, such as infection or delayed healing.
- Test your blood glucose levels more often before this review. For example, four times per day for about two weeks prior which will help your doctor plan your care and adjust your medication, if required.
- Write down all your blood glucose levels in your record book and take it to all appointments.
- Inform all health professionals involved in your care that you have diabetes, as well as your medications, including over-the-counter or complementary therapies.
- Some medications, such as Metformin, may be withheld one to two days prior to a procedure (if contrast dye is used). Insulin and other medication may need to be decreased. Always check with your doctor and ask about pre-procedure instructions.
Day before and day of the procedure
Testing blood glucose level at least four times daily is advised and up to two hourly once fasting or on clear fluids. When fasting, there is risk of low blood sugar levels (hypos). Occasionally, procedures are delayed. Do not ignore hypoglycaemia – report it to the doctor or nurse immediately.
Blood Glucose Monitoring
You should contact your diabetes specialist, doctor or diabetes educator if your blood glucose level is:
- More than 10mmol/L before meals
- More than 15mmol/L two hours after meals
- Less than 4mmol/L
- Ketones are present (type 1)
Take all your medications, insulin, needles and insulin pen with you to hospital.
Type 1 diabetes
For those with type 1 diabetes, insulin should not be delayed or omitted. If on an insulin pump, inform the staff that they are not to disconnect the pump and provide contact details for your diabetes specialist or diabetes educator.
Have a friend or relative drive you home. Check your blood glucose level before leaving the hospital and make sure you are able to eat and drink before discharge.
- After the procedure your diabetes medications and/or insulin should be resumed.
- Check with the doctor when Metformin is to be resumed (usually in one to two days).
- If you have received a dye for radiographic procedures, you may be asked to increase fluids for a few days to flush the dye out of your system.
- Monitor your blood glucose level more frequently for one to two days.
- Hyperglycaemia may occur due to stress or changes to medication. If your blood glucose level doesn’t settle after a few days, consult your doctor.
- Most importantly, when you get home, rest and follow sick day guidelines.