Going under the knife: Who will manage your diabetes?
Stay in control of your diabetes.
November 29, 2013 - Author: Pam Daniels, Michigan State University Extension
Bob, a 76-year-old with Type 2 Diabetes is going into the hospital for a surgical procedure. He’ll be under general anesthesia and will need to stay in the hospital for two days. Bob’s concerned that while his Type 2 diabetes is currently controlled, who manage it while he is in the hospital? Bob wants to be able to keep his Type 2 in-check, using the same regiment that he is currently using. Bob’s concern is that he will be administered too much or too little insulin.
Align yourself with your medical team
What can you do to be sure your condition is properly managed while you are unable to do so? Michigan State University Extension says to align yourself with your medical team.
Surgery can pose added risks for diabetics. One of those risks is the effect surgery and post-operative procedures may have on blood glucose levels. During your hospital stay, health care professionals are in charge of managing your diabetes. You can be included in that care by talking with them in advance about your concerns. Questions to ask include:
- Who will be managing my diabetes for me while I’m in the hospital?
- Will I have a say in what treatments are administered?
- What effects, if any will surgery have on controlling my diabetes long-term?
Take control before your surgery
Typically before surgery a health physical is done. This gives the medical team a roadmap of your health. For diabetics the results are used to determine the best course of diabetes management before, during and post-operative. Patients managing their diabetes by diet alone do not usually need any special measures, providing their existing diet control is adequate. Sharing your concerns ahead of time can be helpful in relieving added stress and anxiety.
Additional topics to discuss:
• Pre-operation, inform your medical team and your family of your current methods for controlling your diabetes.
• Share the history of your blood glucose and how levels affect your overall health.
• Generally, for major surgery or where there is prolonged post-operative starvation, glucose and insulin infusions may be used. Ask if this could happen to you.
• If you take Metformin ask if it should be discontinued 48 hours prior to and subsequent to surgery in order to reduce the risk of lactic acidosis.
• Talk about the day of the surgery. Ask about “nil by mouth” (NPO) and ask for clarity concerning diabetic medications.
• Insulin may be temporarily required in the post-operative phase. Ask what is meant by temporary.
Be prepared. For diabetics facing surgery the best way to maintain control is to get all the facts. Talk with your healthcare provider.