Diabetes and Surgery - Keeping it Safe

Head inside, have surgery, it'll be fine, they said. We do this all of the time, they said. Surgery, nowadays, may be viewed as routine, mundane, and not a big deal. After all, operating rooms are constantly churning patients out, right? Well, yes and no. Surgery is relatively safe, but it isn't without its risks, especially if you have diabetes. 

There are certainly emergent surgical needs. You may not have much say in the matter if you show up in the ER with a hot appendix, for example. That'll buy you a quick ticket to the operating room. But when there's time to prepare for surgery, say you're planning an elective total knee replacement surgery, it's best to get your ducks in a row first. 

Do your homework and ask questions

• Can surgery be avoided, or is it inevitable?
• How many procedures does your surgeon do per year? (Yes, it's OK to ask.)
• What can I do to improve my health before surgery?
• Should I bring my A1C further into range before having surgery?
• Is now a good time?

There are important things to be in-the-know about when you're approaching surgery with diabetes because a diabetes diagnosis places you in a higher surgical risk category. Your mind may be stuck in the current state of affairs with your blood sugars from the moment you heard the word surgery. Health care providers are concerned about your blood sugars too, but they're also focused on your increased risk of post-operative infections, healing time, and mortality. Remember, no one wants you to leave the hospital and have a poor outcome. Health care providers hold your best interests at heart. If they identify a red flag, they may cancel your procedure even if you've made it as far as putting your cap and gown on in pre-op. Clearly, there's more to think about than, Head inside, have surgery. 

It's important to ask questions about your surgery day. Be certain you get answers.

• What adjustments should I make to my diabetes medications the day of surgery?
• When do I need to stop eating and drinking?
• What should I do if my blood sugar gets low before surgery?
• Can I speak to an anesthesiologist a few days before my surgery?
• Can I keep my insulin pump on?
• Will any new medications affect my blood sugar?
• Should I bring extra diabetes supplies?

Approaching your surgical day with normalized blood sugars is important but your other lab work, EKG, and surgical clearance by your health care provider are all vital parts of the puzzle. Other factors may challenge your numbers pre-operatively such as worry and anxiety, but that's to be expected. The stress of the surgery on your body, fluid volumes, medications given, and other factors may impact your blood sugar post-operatively. Although complications can occur with anyone, having a thoughtful plan in place will decrease your risk. 

What's been most helpful for you when preparing for and recovering from surgery with diabetes?