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 you will be asked to stop your diabetes tablets for 24 hours prior to the time of your procedure. If you have poor diabetes control your GP can often assist in the lead up to your surgery.
Most of Dr Wells' patients are day case procedures, which means you will go home on the same day. However, if you are having a major procedure which will require you to stay in hospital at least overnight or require bowel preparations such as colonoscopies then there are a class of newer diabetes drugs called SGTL2i that are often stopped two days prior to your procedure and your surgeon or proceduralist will usually provide guidance to you. The specific drugs involved include Forxiga, Qtern, Xigduo, Jardiance, Jardiamet, Glyxambi, Steglatro, Segluromet, Steglujan, and Invokana, but this list changes as new Brand names emerge and this list should not be considered exhaustive. If in doubt ask your surgeon or proceduralist.
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 you intravenous sugar (dextrose) through a cannula in your arm 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.