One in two people with diabetes will undergo surgery at some point in their life. Every surgery poses potential risks, regardless of your health condition. But people with diabetes face an elevated risk of some complications, such as infection. Fortunately, there are simple steps your health care team can follow to avoid these complications.
Weeks to days before the surgery
- Give your surgeon a list of your current medications, a record of your recent hemoglobin A1c level over the past 3 months as well as any history of ketoacidosis or hypoglycemia. Be sure to indicate if you have experienced any long-term complications of diabetes.
- Keep your blood glucose levels under control in the weeks leading up to your surgery to reduce the chances of infection.
- Certain medical conditions require special care before and during surgery. Let your surgeon know if you have any of the following conditions:
– Type 1 diabetes: These people are at elevated risk of ketoacidosis without the correct dose of insulin.
– Heart issues: Some people may need a stress test before surgery.
– Sleep apnea: Some people may need to be treated, if not already, at least 2 weeks before surgery.
– Chronic kidney disease: Some people may require additional medication during surgery.
Ask your surgeon for the following information so that you can plan accordingly:
- The type and duration of surgery.
- When you must stop eating before the surgery and when you can resume eating afterward.
- How your diabetes medications will change before and after the surgery.
- Should you start taking a medication for high blood pressure?
- Should you stop taking aspirin 7 days before surgery?
- Should you stop taking any of your current medications before the surgery, such as metformin, sulfonylureas, meglitinides, or anti-clotting medications (such as warfarin)?
The day before, and day of, the surgery
- You will probably not be allowed to eat on the day of surgery.
- Many people with diabetes will not require additional insulin therapy immediately before the operation. But ask your provider, just to be sure.
- Be prepared for these potential changes to your medications the morning or day of surgery:
– Stopping anti-hypertension medicines the morning of surgery, except beta-blockers.
– Stopping oral anti-diabetic medicines the day of the surgery.
– If you take insulin, you may need to reduce long-acting basal insulin by up to 50% the evening before to prevent hypoglycemia.
– You will likely be asked to stop taking short-acting insulin the morning of surgery since you won’t be eating. These recommendations are likely to vary based on the type of diabetes you have.
During recovery
After any surgery, rest and good nutrition can help your body recover. Follow these tips, with close guidance from your provider, so that you can become active again in the least possible time:
- Check your home blood glucose level at the frequency recommended and know when to call your provider for levels that are too high or too low.
- Once you’ve started eating normally again, you likely can start taking your normal medications by mouth. Always talk to your provider, but in general, when to start oral medications will depend on your laboratory testing and how much you are eating.
