Preparing for surgery when you have diabetes

You may need surgery for a diabetes complication or for some other problem that is unrelated to your diabetes. Your diabetes may increase your risk for problems during or after your surgery, such as:

  • Infection after surgery
  • Healing slower
  • Heart problems
Before Surgery

Work with your doctor to come up with the safest surgery plan for you.

Focus more on managing your diabetes during the weeks before surgery.

Your doctor will do a medical exam and talk to you about your health.

  • Tell your doctor about all the medicines you are taking.
  • If you take Metformin, talk to your doctor about stopping it. Sometimes, it can be stopped 48 hours before and 48 hours after surgery to decrease the risk of lactic acidosis.
  • If you take insulin, ask your doctor what dose you should take the night before or the day of your surgery.

Surgery is riskier if you have diabetes complications. So talk to your doctor about your diabetes management and any complications you have from diabetes. Tell your doctor about any problems you have with your heart, kidneys, or eyes, or if you have loss of feeling in your feet. The doctor may run some tests to check the status of those problems.

During Surgery

Before surgery, talk to your doctor about maintaining a good blood sugar level during the operation. You may do better with surgery and get better faster if your blood sugar is controlled during surgery. You may be instructed to aim for a blood sugar between 80 and 150 mg/dL.

During surgery, insulin is given by the anesthesiologist. You will meet with this doctor before surgery to discuss the plan to control your blood sugar during the operation.

After Surgery

You or your nurses should check your blood sugar often. You may have more trouble controlling because you:

  • Have trouble eating
  • Are vomiting
  • Are stressed after surgery
  • Are less active than usual
  • Have pain or discomfort

Expect that you may take more time to heal because of your diabetes. Be prepared for a hospital stay if you are having major surgery. People with diabetes often have to stay in the hospital longer than people without diabetes.

Watch for signs of infection, such as a fever, or an incision that is red, hot to touch, swollen, more painful, or oozing.

Prevent bedsores. Move around in bed and get out of bed frequently. If you have less feeling in your toes and fingers, you may not feel if you are getting a bed sore. Make sure you move around.

After you leave the hospital, it is important for you to work with your primary care team to make sure your blood sugar continues to be well controlled.

When to Call Your Doctor

Call your doctor if:

  • You have any questions about surgery or anesthesia
  • You are not sure what medicines you should take or stop taking before surgery
  • You think that you have an infection

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TuDiabetes Talks: Bright Spots and Landmines the book

 

On this TuDiabetes Talks Episode, we interview Adam Brown, about his new book Bright Spots and Landmines. With this book, Adam encourages us to be proactive in our diabetes management and invites us to identify what works and what we need to modify to manage our diabetes in a satisfactory manner.


TuDiabetes Talks: Bright Spots and Landmines the book

On this TuDiabetes Talks Episode, we interview Adam Brown, about his new book Bright Spots and Landmines. With this book, Adam encourages us to be proactive in our diabetes management and invites us to identify what works and what we need to modify to manage our diabetes in a satisfactory manner.


Hypertension and diabetes

About 70% of adults with diabetes have high blood pressure or use prescription medications to reduce high blood pressure. Maintaining healthy blood pressure—less than 130/80 millimeters of mercury (mm Hg) helps to prevent damage to the eyes, kidneys, heart, and blood vessels. Blood pressure measurements are written as a fraction, with the two numbers separated by a slash. The first number represents the pressure in your blood vessels when your heart beats (systolic pressure); the second number represents the pressure in the vessels when your heart is at rest (diastolic pressure).

In general, for every 10 mm Hg reduction in systolic blood pressure (the first number in the fraction), the risk for any complication related to diabetes is reduced by 12%. Maintaining normal blood pressure control can reduce the risk of eye, kidney, and nerve disease (microvascular disease) by approximately 33%, and the risk of heart illness and stroke (cardiovascular disease) by approximately 33% to 50%. Healthy eating, medications and physical activity can help you bring high blood pressure down.

Hypertension is the primary risk factor for cardiovascular diseases, which are the leading cause of death. However, there is a wide disparity in the number of people who are aware of their hypertensive condition, those who are being treated and are not controlled, and those who are being treated and are controlled. This makes it necessary to increase efforts to raise awareness and knowledge about hypertension, as well as initiatives to facilitate access to adequate and evidence-based treatment.

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TuDiabetesTalks: Social Media and diabetes

In this episode of TuDiabetes Talks Mila talks to Deborah Greenwood, CDE, Past President of AADE and DHF Board Member and discusses how social media benefit people with diabetes and shares how is she helping and supporting this new tool.


TuDiabetes Talks: Social media and diabetes

In this episode of TuDiabetes Talks Mila talks to Deborah Greenwood, CDE, Past President of AADE and DHF Board Member and discuss how social media benefit people with diabetes and shares how is she helping and supporting this new support tool.


TuDiabetes Talks: The Insulin Express (podcast)

On this episode of TuDiabetes Talks Mila interviews Oren Liebermann and talk about his upcoming book “The Insulin Express” and his diagnosis story while traveling.


TuDiabetes Talks: Emotional health and diabetes

On this episode of TuDiabetes Talks, Mila will be talking with Mark Heyman Ph.D., Psychologist and new member of our Board of Directors. Mental Health is a topic we don’t hear a lot of, but it’s certainly one we can not forget.


TuDiabetes Talks: The Insulin Express

On this episode of TuDiabetes Talks Mila interviews Oren Liebermann and talk about his upcoming book “The Insulin Express” and his diagnosis story while traveling.

Learn more about Oren and his book at The Insulin Express

To purchase the book: Amazon


What is insulin?

Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.

Insulin plays a major role in metabolism—the way the body uses digested food for energy. The digestive tract breaks down carbohydrates—sugars and starches found in many foods—into glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, cells throughout the body absorb glucose and use it for energy.

Insulin’s Role in Blood Glucose Control

When blood glucose levels rise after a meal, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to cells throughout the body.

  • Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels.
  • Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen.
  • Insulin also lowers blood glucose levels by reducing glucose production in the liver.

In a healthy person, these functions allow blood glucose and insulin levels to remain in the normal range.

Types of Insulin

There are many different types of insulin. The type lets you know how fast the insulin starts working or how long it lasts in your body. Your health care provider will help you find the insulin that is best for you.

  • Rapid-Acting – This insulin starts working within 15 minutes after you use it. It is mostly gone out of your body after a few hours. It should be taken just before or just after you eat.
  • Short-Acting – This insulin starts working within 30 minutes to 1 hour after you use it. It is mostly gone out of your body after a few hours. It should be taken 30-45 minutes before you eat.
  • Intermediate-Acting – This insulin starts working within 2-4 hours after you use it. It reaches its highest level in your blood around 6-8 hours after you use it. It is often used to help control your blood sugar between meals. Some people use this type of insulin in the morning, at bedtime, or both.
  • Long-Acting – This insulin starts working within 2 to 4 hours after you use it. It can last in the body for up to 24 hours. It is often used in the morning or at bedtime to help control your blood sugar throughout the day.
  • Pre-Mixed – This is a mix of two different types of insulin. It includes one type that helps to control your blood sugar at meals and another type that helps between meals.
General Tips
  • Never share insulin needles (syringes) or devices.
  • Ask your doctor or nurse to show you how to inject your insulin.
  • Always wash your hands before you inject your insulin.
  • Do not inject your insulin in the exact same spot on your body each time.
    • The skin may get thick or thin if you use the same spot.
    • Inject in the same general area of your body.
  • Do not use your insulin if it looks cloudy or looks like something is floating in it. Take it back to the drug store for a new one.
  • Do not use insulin needles (syringes), pens, and injectors after the expiration date printed on the label or on the box.

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Who should be part of your health care team?

 

Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and pediatricians. Sometimes physician assistants and nurses with extra training, called nurse practitioners, provide primary care. You also will need to see other care professionals from time to time. A team of health care professionals can help you improve your diabetes self-care. Remember, you are the most important member of your health care team.

Besides a primary care professional, your health care team may include

  • an endocrinologist for more specialized diabetes care
  • a registered dietitian, also called a nutritionist
  • a nurse
  • a certified diabetes educator
  • a pharmacist
  • a dentist
  • an eye doctor
  • a podiatrist, or foot doctor, for foot care
  • a social worker, who can help you find financial aid for treatment and community resources
  • a counselor or other mental health care professional

When you see members of your health care team, ask questions. Write a list of questions you have before your visit so you don’t forget what you want to ask. Watch a video to help you get ready for your diabetes care visit.

You should see your health care team at least twice a year, and more often if you are having problems or are having trouble reaching your blood glucose, blood pressure, or cholesterol goals. At each visit, be sure you have a blood pressure check, foot check, and weight check; and review your self-care plan. Talk with your health care team about your medicines and whether you need to adjust them. Routine health care will help you find and treat any health problems early, or may be able to help prevent them.

Talk with your doctor about what vaccines you should get to keep from getting sick, such as a flu shot and pneumonia shot. Preventing illness is an important part of taking care of your diabetes. Your blood glucose levels are more likely to go up when you’re sick or have an infection. Learn more about taking care of your diabetes when you’re sick and during other special times, such as when you’re traveling.

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General Diabetes Information

Family Health History Quiz

Family health history is an important risk factor for developing a number of serious diseases, including type 2 diabetes. In ...
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What is insulin?

Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells ...
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Who should be part of your health care team?

Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and ...
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Know Your Diabetes ABCs – A1C, Blood Pressure and Cholesterol

Talk to your healthcare team about how to manage your A1C (blood glucose or sugar), Blood pressure, and Cholesterol. This will help lower ...
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How to manage your diabetes?

Healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken ...
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What is Prediabetes?

Prediabetes is a condition in which blood glucose or A1C levels—which reflect average blood glucose levels—are higher than normal but ...
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Diabetes symptoms

Individuals can experience different signs and symptoms of diabetes, and sometimes there may be no signs. Some of the signs ...
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Who is at risk of developing diabetes?

Type 1 diabetes risk factors: The risk factors for type 1 diabetes are still being researched. However, having a family ...
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What is diabetes? 

A group of diseases that result in too much sugar in the blood (high blood glucose). Most of the food ...
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