Diabetes and Surgery

Over 18 million Americans have diabetes and many will require surgery at some time in their lives. For the person with diabetes surgery presents several challenges. Before and after surgery the individual may require adjustments in the diabetes
regimen to maintain acceptable blood glucose levels.

BEFORE SURGERY

In preparation for surgery there are several things you need to do to help manage your diabetes:

  1. Monitor your blood glucose 4 times daily.
  2. Inform the physician who manages your diabetes of impending surgery and obtain recommendations regarding your diabetes medication.
  3. Develop a plan with your physician on how to handle your diabetes medications the day of surgery.


What should your blood glucose levels be prior to surgery? (Based on American Diabetes Association Recommendations)
Before meals: 90-130 mg/dl 1-2 hours after meals: less than 180 mg/dl

DURING SURGERY

Surgery and anesthesia cause the release of stress hormones. These hormones make the body less sensitive to insulin. All individuals with Type 1 diabetes must continue to have an insulin source during the surgery. It may be necessary for individuals with Type 2 diabetes, even if managed before with meal planning, exercise, and oral agents, to have insulin administered during the surgery period.

AFTER SURGERY

A major effect on diabetes after surgery is related to variable food intake and ability to take fluids.  There is a risk of both low and high blood glucose levels due to the stress of surgery and due to possible nausea or vomiting as food is reintroduced.

Management of diabetes after surgery should include:

  1. Frequent blood glucose monitoring
  2. Adjustments to the dose and / or frequency of diabetes medication may be needed.
  3. Based on the type of surgery, the individual may not be able to eat or drink for a period of time. Fluids and food will be introduced as recovery permits.