A successful surgery and recovery for a person with diabetes require careful planning, anticipation of potential problems, and collaboration among various actors. High blood sugar levels, as well as complications related to diabetes such as renal insufficiency and cardiovascular diseases, increase the risks associated with surgery. Before surgery, an assessment of the situation is made and all medications are reviewed.
Pre-surgery assessment
The doctor who refers for surgery may not be familiar with the individual's diabetes management. Before surgery, it is important to contact your diabetes care provider. In addition to reviewing and possibly intensifying medication therapy, it is advisable to review the guidance related to sick days and ensure adequate monitoring tools are in place. It is wise to take care of adequate nutrition and maintain muscle strength with exercise in advance, and to quit smoking if applicable. In addition to blood sugar balance, attention is paid to potential additional diabetes-related conditions and sources of infection, such as in the feet, skin, and mouth.
Diabetes management during surgery
The care of a person with diabetes during surgeries and procedures is always individually planned, taking into account the duration of fasting, possible bowel preparation, and the duration of the surgery. Usual medications can generally be continued until the morning of the surgery, unless otherwise instructed by the care unit.
In larger surgeries, a person with diabetes is usually admitted to the hospital ward the day before the operation. The anesthesiologist responsible for the anesthesia typically meets them then. The surgery is usually scheduled for the morning to allow for a longer post-operative monitoring period on the same day. The anesthesiologist will give instructions on the management of diabetes before, during, and after the surgery. Once the individual is able to measure their blood sugar and can eat normally, they can resume responsibility for their own insulin treatment.
Hospitals have their own detailed guidelines for the management of diabetes during surgery. In long-lasting surgeries and procedures, insulin and glucose solution are administered via intravenous drip. By regulating the drip rate of the solution, blood sugar can be safely adjusted during the operation.