Should my dad, who's scheduled to have an operation unrelated to his diabetes, keep up his normal diabetes routine?

1 answer | Last updated: Jun 22, 2010
A fellow caregiver asked...

My dad, who has type 2 diabetes, needs to have surgery soon for another condition. Is there anything he needs to do differently to manage his diabetes during this time?

Expert Answers

Theresa Garnero is clinical nurse manager of Diabetes Services at California Pacific Medical Center in San Francisco.

Your dad should frequently monitor his blood glucose immediately prior to the surgery. Stress can play havoc on his blood sugar and having an operation is a stressful event. He also needs to ask his anesthesiologist which medications he should continue on the day of surgery. If he's asked not to eat or drink anything before his operation, he may need to reduce his dose of pills or insulin, and he should talk with his diabetes doctor about this before the operation. In addition, it's smart to request that your dad goes first on the surgery schedule to avoid long periods of fasting (going without food), a perfect set up for a roller coaster glucose ride.

Once hospitalized, you can be his diabetes advocate, while the staff takes over his diabetes care around the time of his operation. Ask that his glucose be tested regularly (at least before meals and bedtime). Due to quality control measures, hospitals typically use their own glucose device. If there are any issues with his diabetes that are not being addressed, talk with the physician or charge nurse on duty, or a diabetes nurse educator at the hospital. For example, if he takes diabetes pills at home that were stopped before his surgery, he may need other medicine, including insulin, while hospitalized. Insulin is often necessary for people with diabetes while in the hospital, so regardless of whether or not your dad takes it at home, know that insulin is his ally. If his blood sugar is high during his hospitalization (over 180 milligrams per deciliter) and goes untreated, he's at a much higher risk for a delayed recovery and complications like infection, and even a heart attack or stroke.

Before your dad leaves the hospital, ask his diabetes doctor if his medication regimen has changed and, if so, what the effects of the change may be. For instance, in all likelihood your dad has been much less active in the hospital than usual. If he takes insulin-stimulating pills or insulin, he may be at risk of a low blood sugar episode if he continues to take the same dose of medication when he gets home.