Surgical procedures and anesthetic management are more risky for patients with diabetes. For this reason, surgeons and anesthesiologists must pay special attention to diabetes and its complications. The anesthesia consultation allows the anesthesiologist to assess the patient's diabetic control, to adapt treatments and to ask for additional tests if necessary.
It is important to detail the history of diabetes, diabetes-related complications and treatments (anti-diabetic, insulin, etc.)
The glycated hemoglobin (HbA1c) value is used to assess glycemic control over the previous 3 months:
→ Receive a prescription to measure your diabetes (glycated hemoglobin) before the anesthesia consultation.
Yes, you can continue your treatment.
You can take your medication the day before and the morning of the procedure.
It will be necessary to suspend certain treatments on the morning of the operation.
Diabetes medications should not be taken on the morning of the procedure. Only metformin should not be taken the night before or the morning of the operation.
Slow insulin injections should be continued as usual, especially if you have type I diabetes (usually since childhood). To avoid insulin-related hypoglycemia and fasting for anesthesia, an infusion with glucose will be started at breakfast time or when you arrive at the operating room.
Despite these recommendations, only your anesthesiologist can suggest a protocol adapted to your situation.
The operative risk is mainly related to the complications of diabetes, in particular:
Some complications of diabetes may worsen or develop during surgery:
To reduce diabetes-related complications during surgery, it is necessary to have a complete preoperative assessment to ensure that diabetes is balanced.
Your glycemia will be checked at your arrival, during the procedure and afterwards.
If you experience symptoms of hypoglycemia in the hospital, please report it to your doctor so that your blood sugar can be monitored. Blood sugar levels will be monitored throughout your care with appropriate treatment.
Don't hesitate to check your blood sugar more frequently.
Depending on the evolution of the operation, you may be able to eat again a few hours after the procedure. More frequent glycemic controls will be carried out and the resumption of your usual treatments can be envisaged in the absence of complications.
Sometimes, insulin treatment may be prescribed by the medical team during your hospital stay to help balance blood sugar levels and compensate for the discontinuation of certain treatments.
Your diabetes may become temporarily unbalanced.
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About 38% of adult patients suffer an adverse event during or following their surgery, researchers reported Wednesday in the BMJ.
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60% of the complications were potentially preventable and 21% were definitely or probably preventable, researchers report.
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