Day surgery and diabetes

Planning for the Procedure

If possible, you should plan for your procedure. You should ideally:

•  Make an appointment with your diabetes specialist, General Practitioner and/or diabetes educator before your operation or procedure.
• Check your blood glucose levels more often before seeing your diabetes team. For example, four times per day for two weeks before so that it can help your doctor plan your care and adjust your medication, if needed.
• Keep your blood glucose levels within the target range before the surgery, as this will lessen the chance of complications, such as infection or delayed healing.
• Write down all your blood glucose levels in your record book and take it to all appointments.
• Let all health professionals involved in your care know that you have diabetes and give them a list of your medications, including over-the-counter or complementary therapies.
• You may be asked to stop taking some medications, such as Metformin, for one to two days before a procedure (if contrast dye is used). Insulin and other medication may need to be reduced. Always check with your doctor and ask about pre-procedure instructions.

Day before and day of the procedure

You could check blood glucose levels at least four times a day and every two hours when you’re fasting or on clear fluids. When you fast, there is risk of low blood glucose levels (hypoglycaemia or hypos) especially if procedures are delayed. Do not ignore hypoglycaemia – report it to the doctor or nurse as soon as possible so that they can help you treat it straight away.

Blood Glucose Monitoring

You should contact your diabetes specialist, doctor or diabetes educator if your blood glucose level is:

•  More than 10mmol/L before meals
•  More than 15mmol/L two hours after meals
•  Less than 4mmol/L
•  Ketones are present (type 1)

Take all your medications, insulin, needles and insulin pen with you to hospital.

Type 1 diabetes

If you have type 1 diabetes, do not skip or stop your insulin. If you use an insulin pump, let the staff know that they are not to disconnect the pump. Instead, give the staff the contact details for your diabetes specialist or diabetes educator so that they may discuss any questions they have with them.

Going home

• Have a friend or relative drive you home. Check your blood glucose level before leaving the hospital and make sure you are able to eat and drink before discharge.
• After the procedure, your diabetes medications and/or insulin should be restarted.
• Check with the doctor when metformin is to be restarted (usually in one to two days).
• If you were given a dye for radiographic procedures, you may be asked to drink more fluids for a few days to flush the dye out of your system.
• Check your blood glucose levels more frequently for one to two days.
• Hyperglycaemia (blood glucose levels above 10mmol/L) may occur because of stress or changes to medication. If your blood glucose levels do not return to target range after a few days, see your doctor.
• Most importantly, when you get home, rest and follow sick day guidelines.