Your surgeon or the hospital will generally advise you on whether there will be any change to your usual diabetic tablets or insulin.
However, IF you are advised to do so by your anaesthetist, these are our usual instructions for management of your diabetes prior to your surgery. Do not follow these unless specifically advised to do so by your anaesthetist.
If you take tablets:
Usually, depending on the procedure, you are typically asked to skip your diabetes tablet (eg metformin) on the day of your procedure. However, there are certain newer diabetes drugs we may ask you to stop several days prior to a procedure (eg forxiga, jardiance, invokana) and the hospital (or surgeon) will often provide guidance. If you have poor diabetes control your GP can often assist in the lead up to your surgery.
If you take insulin:
Surgery in the Morning:
For patients on insulin and having surgery in the morning, they should skip their morning dose of short-acting insulin (eg actrapid, humalog, novarapid) and have half of the dose of their longer-acting insulin (eg protaphane, mixtard 30/70) on their arrival at hospital. At your arrival, the nurses will do a blood sugar level, and we may give intravenous sugar (dextrose) if that is required, dependent on the situation.
Surgery in the Afternoon:
For patients on insulin and having surgery in the afternoon, they should have half their usual morning dose of short-acting insulin with their early breakfast (eg actrapid, humalog, novarapid) along with half their usual dose of their longer acting insulin (eg protaphane, mixtard 30/70). They should check their blood sugar levels during the day, and we will do the same on admission to hospital. If required, we will give you some dextrose intravenously.