No Date: Diabetes and Surgery ??

Hi all, I wondered if any of you had to deal with diabetes when you had your surgery? My Diabetes got out of control because a new med was not working; I'm getting it back on track now, but wondered if that was a big concern going into a major surgery and if so, did your doctor have any specific concerns/suggestions, anything? I know recovery could be longer and a surgery could send my glucose high, but did it put you at any greater risk?
Any info would be appreciated.

Thank you!
Elfi (Lisa)

Hi Elfi -

Here is an article on Diabetes and Hysterectomy that may provide information.

We also have lots of ladies on this site, so hopefully one with diabetes will see this post and respond.

I have brittle diabetes. My a1c was high before my surgery from the stress of heavy bleeding.

My doctor continually made comments about being worried about my diabetes before surgery. However, when I arrived for surgery with a 99 reading after fasting he was happy. (It was 79 when I woke at 6am but came up from dawning effect.)

The only problem I had was getting my insulin while in hospital. That hospital and town has no endocrinologist. So you can imagine the senerio with the gynecologist ordering my insulin dosage while in hospital.

My experience from being a diabetic for 40+ years is doctors always goes on and on about diabetes, but other than the fact it takes longer to heal it doesn't become an issue.

For example my doctor went on an on about my out of control diabetes but never checked A1c before surgery. My assumption is he just wanted it noted in case there was complications. Also any problem I have now (itching, dry skin, etc) he says is because of diabetes.

Good luck.

Thanks Katie and marestail. I wondered if it was not "under control" if they would hold off on surgery. I hope not because whenever I get there I'm going to want it done ASAP. I've named my fibroid tumor Fred and I want Fred gone!

I'm in the pre-diabetic stage (they look at my chart and freak out because I was listed as diabetic at one point), they never checked my A1C, but before I was released I got what felt like 5 warnings to watch my sugar as it might interfere with healing if it got too high.

Curious about this, as well. I was diagnosed last August with type 2, and I've been controlling it on my own with diet and weight loss. My last A1C was 5.3. I still wonder about controlling my sugar during the inactivity post surgery.

5.3 Great job! Mine was out of control due to new meds and a lot of stress from work, but I'm working on getting it back under control. Dr. will probably monitor it closely. Trying not to worry too much about it, but it is always on my mind.

Elfi,
I am on an insulin pump. At my pre-anesthesia visit, the anesthesiologist was fine with me being in control of my insulin and BG while in the hospital. They just wanted a sliding scale to cover high blood glucose and how do I deal with low blood glucose (I am allergic to dextrose).
At my pre-op visit with my surgeon, he wanted to know who would be writing orders for my diabetes while I was hospitalized. It was then that he ordered my A1c. Fortunately the lab still had blood on hand from my pre-op draw to run it. It was 6.2%, I had increased stress due to breaking my ankle during the pre-op preparations.
I wrote up my routine, including sliding scale and how to operate my insulin pump and sensor. Then submitted to my PCP who I see for my diabetes (she is a CDE specializing in diabetes). She wrote a cover letter saying that I could manage my own insulin and blood sugars while hospitalized.
The anesthesiologist had asked that my pump site be placed high on one arm and my sensor high on the other arm so they would be accessible for anesthesia and out of the way of any blood pressure cuff.
After surgery, during recovery at home, about one week post-op, I started to run higher and higher blood glucose levels until I was taking 64x my regular insulin basal rate just to keep my BG below 200. My goal is set at 100 and my high alarm goes off at 140.
It was the weekend (Friday afternoon) and the on-call doctor did not want to order antibiotics for me. I had run low grade fevers during the whole first week, but by the weekend I was using more Tylenol and very little narcotics, so my temperature was probably masked. By the time I made contact with my doctor's office and received my prescriptions it was 7pm Monday evening.
I did have an infection in my umbilical incision. I had terrible nausea, irritable bladder and bladder spasms from the antibiotics. That set me back more than any problems with my BG.
I suggest keeping in touch with your provider that manages your diabetes. Have them send a letter to your surgeon outlining how your care should be managed.
Watch for signs of infection and let your surgeon know as soon as possible so you can keep on top of any problems.
I found that when I would talk to the nurse in my surgeon's office, only the number one issue was addressed, such as needing my catheter out. I am not sure the fact that I was running a low grade fever was even brought to the attention of my surgeon until it was the primary issue.

and prayers for you
as you prepare for your surgery.
DH


Always remember your health care providers are the ones that know you and your needs and should be your best resource for answers to your questions.