As a person with diabetes you have many daily activities that are necessary, beyond what others need to do. You learn to acclimate, check your blood sugars regularly, modify what and how you eat, and make dealing with your diabetes part of your routine. It doesn’t impede you from having a normal life – you just have to take extra care to do so.
Similarly, diabetics face unique challenges when undergoing a surgery. The most common issues a diabetic person may face when undergoing a surgery relate to:
- infection at the site of the surgery afterwards
- healing more slowly than expected
- heart problems, fluid/ electrolyte issues
- kidney problems (see our article, Surgical Complications for Diabetes for more info).
Knowing that you have an increased risk for complications can allow you the opportunity to prepare more thoroughly for your procedure. The following guidelines are intended to help with preparing for a surgery as a diabetic, to ensure the safest possible surgery. As always, talk to your primary care physician and surgery team to examine your specific needs and risks, as they will have the best idea of how the procedure will work, and how your unique situation should be handled.
Many diabetic patients worry about having surgery – which is an entirely normal response – yet modern medicine has made surgery safer than ever before. Despite the relative safety of a procedure, it never hurts to take extra care in the weeks and months leading up to a surgery to give yourself the best possible odds. The following tips are general guidelines that patients with diabetes should consider when preparing for an operation.
First and foremost is monitoring your sugar levels.
Your doctor may request that you take readings more frequently 3 days prior to the procedure, and particularly the day of. This helps to give the surgical team (and the anesthesiologist who will administer your insulin during the surgery) up to date information about your resting rate and normal fluctuations. The type of insulin you take is a factor as well, and may need to be modified in the hours leading up to your operation.
Beyond this, you should talk to your doctor about any other medications you take.
You may need to stop taking some (like metformin) or change your doses on others. This includes natural supplements – even something as innocuous as chamomile tea can interact with your medications and increase your chance of bleeding. If you have a question about any of them – speak up!
Make sure you are thorough in your new routines, and ask for a print out of any new dosing guidelines if it will help you remember.
Follow up to ensure you are aware of exactly what your doctor wishes you to do. Your safety is their top priority. If you have made an advanced care plan (document stating how you wish to have your medical care handled in the event of emergency or complications) you should bring it, or look into making one if you have not already.
It is very important to have an empty stomach the day of surgery; however, this can lead to lower sugar levels.
Discuss with your doctor exactly when you should stop eating/drinking, and how to handle your levels during this sensitive time. If you do not have an empty stomach the day of surgery your operation may be cancelled, so it is important to follow instructions carefully to avoid further delays.
On the day of your surgery you may feel a bit nervous and jittery. This is ok. Try to find a small routine that calms you that doesn interfere with the surgery preparations above, like reading a book, listening to soothing music, or taking a nice hot shower. Once you have done this, remember the following before heading in to the office:
- Bring your photo ID, advanced care plan, and any other documents with you.
- Make sure you have an empty stomach, and have followed medication protocol given by your doctor. If you have been instructed to take any pills, use just a small sip of water to take them with
- Remember to shower the day of your operation, and avoid wearing any jewelry, make up, lotions, perfumes, or contacts to the procedure.
- Do not shave the surgery site yourself. Let them handle this in the operating procedures.
- Remember to have someone along to drive you home afterwards. The anesthesia may make you sleepy or numb, and you may also be given pain medication post-op, making it unsafe for you to drive.
- Your doctor will give you specific instructions for aftercare- follow them!
If you have any questions about how an aftercare item should be handled, call and ask! Remember, your doctor’s primary concern is to get you healthy and well in the safest possible manner. Properly preparing for surgery as a diabetic is in everyone’s best interest!
More than anything, controlling your blood sugar is a diabetics main asset to a speedy recovery. Following these guidelines and aftercare procedures will help to ensure you can resume your normal routine in a timely manner. If you have any concerns or questions, write them down and speak to your doctor about them. You deserve to have the surgery you need without fear. If you take preparing for surgery as a diabetic seriously, you will allow yourself the best chance of surgical success.
Sources:
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ug3768
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452499/
https://medlineplus.gov/ency/patientinstructions/000702.htm
https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444