Diabetic patients need to pay particular attention to their diet and medication on the day of surgery. Individual management of each diabetic provides the best and safest management. Prior to the day of surgery, patients should contact the physician who manages their diabetes. This will allow a specific plan for their diabetic management on the evening before the day of surgery.
In general, the following guidelines are suggested for diabetic patients:
Type 1, juvenile or insulin dependent diabetics:
Patients on insulin pumps should continue using their pumps up to, during and after surgery using a basal rate only. Their routine use may be resumed after they commence their usual diet.
Patients on long acting insulin such as NPH, Lente or Ultralente should take their evening dose as usual but reduce any morning doses by 1/3 if the surgery is in the morning, or by ½ if in the afternoon. Regular insulin should be held until a regular diet is resumed.
Patients on long acting insulin such as Lantus should reduce their evening dose prior to surgery by 20%. Regular short acting insulin should be withheld until diet is resumed after their surgery.
Type 2, adult onset diabetes or non-insulin dependent diabetics:
Patients should avoid taking their oral diabetic medication the night before surgery. This medication may be resumed the night after their surgery once they have resumed their diet.
Patients with type 2 diabetes who take insulin should follow the guidelines for type 1 diabetes.
All diabetic patients should continue to monitor their blood sugars before and after their surgery. Blood sugars will be monitored during your stay by Rancho Mirage Surgery Center staff. Because anesthesia and surgery is a stressful time, blood sugars may fluctuate and require more frequent monitoring during the first few hours after surgery.
Fasting guidelines are the same for diabetic or non-diabetic patients.
If you take medications regularly for heart and lung conditions (such as angina, chest pain, high blood pressure or asthma) or for seizure (epilepsy) control, we recommend that you continue to take them on your usual schedule including the day of surgery. These may be taken with water. However, the preoperative nurse may request that you hold your last dose of certain blood pressure medicines, such as lisinopril and other ACE inhibitor medications. During your preoperative phone call, our nurse will discuss your medications and indicate which ones, if any, to not take on the morning of surgery.
We recommend most adult patients with diabetes not eat anything after midnight before surgery and that they not take insulin or other diabetic medications the morning of surgery. The parents of children with diabetes should contact their physician or an anesthesiologist at Rancho Mirage Surgery Center