can anyone tell me,,,, im due an operation on xmas eve if blood sugers are high during and after it will it affect either the actual operation or the recovery?
operation and high sugar?
- Thread starter jessie01
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Karen.G.
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Hi Jessie
A few years back I had to have an operation on my elbow. The operation was cancelled twice as my Hba1C was too high. The reason I was given was that it takes a diabetic longer to get over things/prone to infections and the time it takes to heal.
This was just my experience, so hopefully others will be able to help also.
Karen
A few years back I had to have an operation on my elbow. The operation was cancelled twice as my Hba1C was too high. The reason I was given was that it takes a diabetic longer to get over things/prone to infections and the time it takes to heal.
This was just my experience, so hopefully others will be able to help also.
Karen
Sid Bonkers
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I think this is a question best asked of your surgeon who will have all your medical details and will know the procedure you are about to have performed. I'm sure you will be in safe hands but for piece of mind ask your surgeon before the op :thumbup:
Best wishes and I hope you are still able to enjoy xmas after your op :thumbup:
Best wishes and I hope you are still able to enjoy xmas after your op :thumbup:
hi thankyou both, reason i ask is am pre diabetic ( if thats the right term) my last hba1c was 45mmols in april,,, ive been having lots of symptoms latly and been doing tests again after not doing any since april when i did a couple fo spot checks and im regulay hitting 17 2 hours after food and my morning test is nearly always above 10,,,, i know that coupled with the symptoms means maybe now i am diabetic,,,, i am going fri to have bloods taken again for a hba1c after having seen an incredibly dismissive nurse last week and said i was concerned. the operation is to remove a cyst in my head im terrified enough i also have 5 children im worried this will affect things,, ,ive not got my pre op till the 11th dec, :-( i guess by then i should know the results of fridays bloods.
Once you get your HbA1c result, I would make an appointment with your GP and discuss things with him/her. Don't be put off with "the nurses handle diabetes patients"; you have the right to talk to your doctor - and I'd mention the dismissive nurse, too! Ask your GP what will happen in hospital and how you'll be taken care of.
Make your concerns known to the hospital team, and make sure you tell them that you have been having high blood glucose readings. If you are diagnosed diabetic by the time you have your op., it will mean they'll put you up at the top of the list, so with any luck you'll be first in. I was in last Boxing Day for a day-surgery gynae op and all went brilliantly. The nurses were wondeful - though they really don't seem to know much about diabetes, they don't get much in their training. They need to make sure, though, that your blood sugars aren't too low after the operation
The best way I find to keep my blood glucose low is to control my carbohydrate intake; try it. It means cutting out bread, potatoes, rice , pasta etc, cereals and all baked goods. Have a look at the Low-carb Forum on here for more ingo. If it works for you, then stick with it.
Come back on here once you've got your HbA1c result, and we'll do our best to help you. Let us know if you're on meds, and what the doctor has said. Being only 3 weeks diagnosed when you have an operation can't be fun, but we'll support you all we can. Are you just in for the day, or over Christmas?
Viv 8)
Make your concerns known to the hospital team, and make sure you tell them that you have been having high blood glucose readings. If you are diagnosed diabetic by the time you have your op., it will mean they'll put you up at the top of the list, so with any luck you'll be first in. I was in last Boxing Day for a day-surgery gynae op and all went brilliantly. The nurses were wondeful - though they really don't seem to know much about diabetes, they don't get much in their training. They need to make sure, though, that your blood sugars aren't too low after the operation
The best way I find to keep my blood glucose low is to control my carbohydrate intake; try it. It means cutting out bread, potatoes, rice , pasta etc, cereals and all baked goods. Have a look at the Low-carb Forum on here for more ingo. If it works for you, then stick with it.
Come back on here once you've got your HbA1c result, and we'll do our best to help you. Let us know if you're on meds, and what the doctor has said. Being only 3 weeks diagnosed when you have an operation can't be fun, but we'll support you all we can. Are you just in for the day, or over Christmas?
Viv 8)
I had knee surgery on Tuesday with an HBA1C of 6.4 and that morning's reading being 5.4. The leaflet says above 15 may delay your surgery. They checked my levels on arrival and I think sometime whilst asleep, but that was it! Last week I had a biopsy under local, checked on arrival then not again in over 5 hours. Amazed at their poor understanding and lack of checks tbh.
I doubt they will operate if you arrive reading 17.
Ali
I doubt they will operate if you arrive reading 17.
Ali
well,,,, seems the dismissive nurse owes me an apology,,, just been called from gp and given my blood test results,,,, my hba1c was 45mmols in april,...... one taken last friday is 68mmols which converts to 8.2 i have an apt tomoro with the nurse but im guessing i will diagnosed at that level? :?
Hi Jessie - welcome to the club! 
I was diagnosed with an HbA1c of 6.5, so you are one of us!
In amongst everything else the nurse says to you, make sure you ask her about your operation. For instance, if she gives you Metformin (which I'm sure she will), you shouldn't take it on the day of your operation. By the way, you should build up the dose - from 1 a day for a week, then 2 a day for the next week, etc. You may get gastric side effects, in which case you should ask for the Slow Release version.
In fact, since your operation is so close, it might be worth asking if it would be better to delay starting it until after you've had the op.
She'll offer you statins - ask her to give you a print-out of your lipid profile and to tell you why she wants you to take them. Then make up your own mind. Most people get on with them very well - some don't.
She should also check the pulses and feeling in your feet and lower legs. You'll eventually be given an appointment to have your retinas checked - nothing to worry about, just eye drops and a photo.
I'm jumping the gun a bit here - you'll have a lot to take in. Have a look on the "Greetings and Introduction" bit on the Board Index, for the Information for Newbies that Daisy1 posts for everyone who is newly diagnosed. Maybe post a thread on the Greetings bit so that Daisy spots you. The main thing is, not to panic. You've had a diagnosis, at least. You're not going to drop dead tomorrow, so take your time to take everything in.
Let us know how you get on with the nurse.
Viv 8)
I was diagnosed with an HbA1c of 6.5, so you are one of us!
In amongst everything else the nurse says to you, make sure you ask her about your operation. For instance, if she gives you Metformin (which I'm sure she will), you shouldn't take it on the day of your operation. By the way, you should build up the dose - from 1 a day for a week, then 2 a day for the next week, etc. You may get gastric side effects, in which case you should ask for the Slow Release version.
In fact, since your operation is so close, it might be worth asking if it would be better to delay starting it until after you've had the op.
She'll offer you statins - ask her to give you a print-out of your lipid profile and to tell you why she wants you to take them. Then make up your own mind. Most people get on with them very well - some don't.
She should also check the pulses and feeling in your feet and lower legs. You'll eventually be given an appointment to have your retinas checked - nothing to worry about, just eye drops and a photo.
I'm jumping the gun a bit here - you'll have a lot to take in. Have a look on the "Greetings and Introduction" bit on the Board Index, for the Information for Newbies that Daisy1 posts for everyone who is newly diagnosed. Maybe post a thread on the Greetings bit so that Daisy spots you. The main thing is, not to panic. You've had a diagnosis, at least. You're not going to drop dead tomorrow, so take your time to take everything in.
Let us know how you get on with the nurse.
Viv 8)
daisy1
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viviennem said:
Hi Jessie - I have posted this information for you on your other thread but here it is again for you to make sure that you have the opportunity of seeing it.
BASIC INFORMATION FOR NEW MEMBERS
Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.
A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.
On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.
The role of carbohydrate
Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.
If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.
The bad news
Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.
The good news
People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.
Controlling your carbs
The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:
- Reduce your carbohydrate intake
- Choose ‘better’ carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.
The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.
Choosing better carbohydrates
Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html
The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.
Read more on carbohydrates and diabetes
Eating what works for you
Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.
To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.
The blood sugar ranges recommended by NICE are as follows:
Blood glucose ranges for type 2 diabetes
- Before meals: 4 to 7 mmol/l
- 2 hours after meals: under 8.5 mmol/l
- Before meals: 4 to 7 mmol/l
- 2 hours after meals: under 9 mmol/l
- Before meals: 4 to 8 mmol/l
- 2 hours after meals: under 10 mmol/l
Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
- structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
- self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education
Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.
You may also be interested to read questions to ask at a diabetic clinic
Note: This post has been edited from Sue/Ken's post to include up to date information.
thankyou, i just got back. have been given a meter and strips,, she is starting me on glyx something,,,,,,, was one tablet a day for a week then 2 then she changed her mind and said start on 2 a day one morning one night..... bit shocked as she has a feeling im alte onset type one rather than just a type 2..... am refered to hospital........ have to tell the pre op on 11th apparently they will cancel a op if hba1c is 8.5 or highger she worked mine out as 8.4 i will be devestated if this leads to my op being cancelled,,,, she told me to loose weight and said i qualify for tablets to help with weight loss ( shocked at that ) she i can have hypos as a result of the medication and im strictly not to get pregnant ( not trying anyway) i asked about the low carb thing she seems to think its a good idea as anything like that would help me loose weight.......... got to back in 2 weeks to see her unless i need to call her sooner.x
and thankyou daisy habve had a read of that and had quite a look around the site in general read some interesting posts and info etc..... i am sure there is lots more yet to read though
Your meeting with the nurse seems to have gone okay.
I believe Gliclizade can cause hypos and that's why she's given you a meter and strips - lucky you! Don't forget that you are also entitled to free prescriptions now, because you're on meds - unless you are already getting them of course. Ask the practice reception or your pharmacist for a form (I think).
There are a number of late onset Type 1s who are regular posters on here, so you'll have support from them if you have any questions. Seems your nurse has some idea of what she's talking about - some HCPs don't seem to have heard of it! :shock: I'm impressed that she's okay with you going low-carb. Also good that you're going to the hospital clinic - should be the best possible care there :thumbup: .
Have a good read round so you can go to your clinc appointment armed with lots of questions.
For a basic low-carb diet, have a look at Vi'v's Modified Atkins Diet , which is a Sticky Thread on the Low-carb bit of the Forum. When I stick to that diet as laid out there I lose weight very well - unfortunately I've not been so strict recently and my carbs (and weight ) are creeping up a bit . After Christmas I'll grab myself by the sruff of the neck and really get down to it again.
If my diet is too low-carb for you, get a carb counter book (Collins do one in their Gem series) and add in extra carbs from Low GI veg etc until you reach a level you're comfortable with. Since there is a possibility of hypos with your meds, you'll probably be better off with extra carbs, at least until you know what you're doing. If you feel funny and your BGs are below 4, eat or drink something (Glucose tabs, 2 or 3, or Lucozade) to get your sugars up. There's much more info about hypos elsewhwere on the site, so have a good look round. I don't get them, so I only know the very basics. But I still carry glucose tablets :wink:
Anyway, great that you have a diagnosis, and great that you have a meter and strips . Don't be afraid to ask any questions you like - there's no such thing as a silly question! :crazy:
Viv 8)
I believe Gliclizade can cause hypos and that's why she's given you a meter and strips - lucky you!
Don't forget that you are also entitled to free prescriptions now, because you're on meds - unless you are already getting them of course. Ask the practice reception or your pharmacist for a form (I think).There are a number of late onset Type 1s who are regular posters on here, so you'll have support from them if you have any questions. Seems your nurse has some idea of what she's talking about - some HCPs don't seem to have heard of it! :shock: I'm impressed that she's okay with you going low-carb. Also good that you're going to the hospital clinic - should be the best possible care there :thumbup: .
Have a good read round so you can go to your clinc appointment armed with lots of questions.
For a basic low-carb diet, have a look at Vi'v's Modified Atkins Diet , which is a Sticky Thread on the Low-carb bit of the Forum. When I stick to that diet as laid out there I lose weight very well - unfortunately I've not been so strict recently and my carbs (and weight
) are creeping up a bit . After Christmas I'll grab myself by the sruff of the neck and really get down to it again.If my diet is too low-carb for you, get a carb counter book (Collins do one in their Gem series) and add in extra carbs from Low GI veg etc until you reach a level you're comfortable with. Since there is a possibility of hypos with your meds, you'll probably be better off with extra carbs, at least until you know what you're doing. If you feel funny and your BGs are below 4, eat or drink something (Glucose tabs, 2 or 3, or Lucozade) to get your sugars up. There's much more info about hypos elsewhwere on the site, so have a good look round. I don't get them, so I only know the very basics. But I still carry glucose tablets :wink:
Anyway, great that you have a diagnosis, and great that you have a meter and strips
. Don't be afraid to ask any questions you like - there's no such thing as a silly question! :crazy: Viv 8)
Sorry to have to say this but in my experience BG control whilst in hospital can be very "hit and miss".
If it were me going into hospital I would insist on looking after myself as far as is possible.
I know of a relative who is T2, whilst in hospital she was simply fed all the wrong things and injected with insulin.
The result was she went unconcious, (Hypo??) and it was a near thing, she still has no idea what happened.
I know some hospitals and nurses are good, but there are some iffy ones as well!
H
If it were me going into hospital I would insist on looking after myself as far as is possible.
I know of a relative who is T2, whilst in hospital she was simply fed all the wrong things and injected with insulin.
The result was she went unconcious, (Hypo??) and it was a near thing, she still has no idea what happened.
I know some hospitals and nurses are good, but there are some iffy ones as well!
H
hallii said:
I agree with you on that, Hallii - one of my cousins, who is a graduate nurse of about 15 years experience, only knows about putting all diabetics on sliding-scale insulin, which I think would have hideous consequences for Type 2s who are mainly diet controlled - and on anyone taking insulin-stimulating drugs.
I understood Jessie to mean she had been referred to the hospital Diabetes Clinic, as she is suspected of being late-onset Type 1. Her care during her operation is something she needs to discuss with them, to make sure she is properly looked after.
Jessie, make sure you get an answer to how your diabetes will be looked after in hospital, when you go for your pre-op. Then you can make plans.
Viv 8)
thanks all for commenst etc,,,, yes i think the referal to hosp was because of they are not sure type 2 or late onset type 1 ( i must confess i compeltely went to the apt excpecting to be told 2 because of my weigtht i didnt think at all that maybe just maybe its anything else) when i had gd ( its just over 2 years since i was diagnosed with that which i then had for 7 months till i gave birth) and i had pretty good hypos awarness then as had quite a few..( was on insulin from 11 weeks pregnant) im hoping that means i will be fairly aware if this starts to happen? my pre op is on the 11th dec will make sure i mention the whole diabetes thing as i doubt i will have been seen by the diabetes people at hosp before then.... im also slightly worried they may cancel the op as the nurse said that at 8.5 they may cancel and she converted my 68mmols to a 8.4 so hhmmnnnnnn..... will the nurse have automaticlly added test strips and needles for to get on prescription??? this one will sound daft,,, i hate the meter ive been given,,,,, after years of using a certain one for my eldest whose a type 1 ( also has cerbral palsy so we have to do all her stuff for her) and having had the same meter for myself when pregnant im finding it hard to use a different make! will i get told to jog on if i ask to use the meter i allready have and need the strips to go with it? wondering if the meter ive been given is a cheaper make,,,, strips to go with it i dont know if there is a difference...... x p.s trying SO SO hard with my food and for the first time in quite a while i feel hungry !
My practice gives every diabetic a meter and strips, all the same 'cos if they buy in bulk they're cheaper, I think.
If you watch your carb intake from now on, you should make a bit of difference to your fasting BGs by Christmas Eve - with any luck! Eat a bit more protein and fat to stop your hunger pangs - or eat small meals more frequently.
I had a friend who went from GD in her early 40s straight to Type 1. She lived until she was 93!
Is your op in Day-care, or will you be in for a few days?
Viv 8)
If you watch your carb intake from now on, you should make a bit of difference to your fasting BGs by Christmas Eve - with any luck! Eat a bit more protein and fat to stop your hunger pangs - or eat small meals more frequently.
I had a friend who went from GD in her early 40s straight to Type 1. She lived until she was 93!
Is your op in Day-care, or will you be in for a few days?
Viv 8)
Let's hope you have a good surgical team.
Diabetics don't heal well [hence the comparatively high level of amputations!!], although Ifind I heal normally. I put it down to keeping my blood glucose in the NORMAL range. I can't see any reason why any other blood Glucose level should be an acceptable target. the leaflet with my blood test strips says that a normal blood glucose for a non-diabetic is Fasting < 5.6mmol/l: 2 hours post meal ,7.8 mmol/l .
Bernstein gives a random Bg value for non-diabetics as 4.7mmol/l
I try for these levels or lower pretty much all the time. Being human I do sometimes miss, but I haven't personally hit a fasting of above 5.1mmol/l in years or seen anytrhing above 7.5 mmol/l t any time. VEry rarely do i hit 6
Hana
Diabetics don't heal well [hence the comparatively high level of amputations!!], although Ifind I heal normally. I put it down to keeping my blood glucose in the NORMAL range. I can't see any reason why any other blood Glucose level should be an acceptable target. the leaflet with my blood test strips says that a normal blood glucose for a non-diabetic is Fasting < 5.6mmol/l: 2 hours post meal ,7.8 mmol/l .
Bernstein gives a random Bg value for non-diabetics as 4.7mmol/l
I try for these levels or lower pretty much all the time. Being human I do sometimes miss, but I haven't personally hit a fasting of above 5.1mmol/l in years or seen anytrhing above 7.5 mmol/l t any time. VEry rarely do i hit 6
Hana
etmsreec
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The other thing to bear in mind with your op is if they give you cortizone as a pain killer it can elevate the blood glucose. So, you might have an interesting time keeping your levels down post-op. this is something that you should be able to discuss with the surgeon or their registrar.
If you are going into hospital for planned surgery then there is a recommended standard of care. The following site explains this,
http://tinyurl.com/6xtjqoy
I was not being given the correct pre-op help and support prior to surgery, so I copied this off and trotted along to my GP with it. Things certainly changed from then on. I am a Type 1 diabetic and was being told to not take my insulin and to be nil by mouth on the day of surgery. However I was expected to get up very early in the morning and travel 27 miles to the hospital on the day of surgery. There are surges of several hormones in the morning which are known to raise the blood sugar and the stress of undergoing surgery also increases chemicals in the body that raise the BS. I knew this but apparently my GP and the surgeon did not - I had to explain it to them and request the support of a diabetes team.
Pre-op care for planned surgery should be done with the help and support of a knowledgeable team, there should be little need to cancel planned surgery because of high blood sugars if the diabetes specialist team is involved in planning the care. After all a blood sugar can be raised because someone is dehydrated, if the hospital is old fashioned and tells people to stop eating and drinking at 10pm the night before. A specialist team would know this, along with the knowledge that pre-op stress and not taking morning medications can also raise the BS.
All of this was dealt with by the hospital diabetes specialist team, after my GP talked with the surgeon and diabetes consultant. GPs are now taking the role of co-ordinating care, so they should all be highly aware of the NHS Diabetes document re improving standards in pre-op care for people with diabetes - as should we as the people with this condition.
.
After 50 years of integrating diabetes into my life and learning about its effects, plus years as a surgical ward sister, one thing I am sure about. Diabetes does not delay healing or prevent wounds from healing, prolonged high blood sugars do. If you have the help and support to keep blood sugars stable both before and after surgery you should be ok.
I hope this helps in obtaining the help and support you need,
Liz
http://tinyurl.com/6xtjqoy
I was not being given the correct pre-op help and support prior to surgery, so I copied this off and trotted along to my GP with it. Things certainly changed from then on. I am a Type 1 diabetic and was being told to not take my insulin and to be nil by mouth on the day of surgery. However I was expected to get up very early in the morning and travel 27 miles to the hospital on the day of surgery. There are surges of several hormones in the morning which are known to raise the blood sugar and the stress of undergoing surgery also increases chemicals in the body that raise the BS. I knew this but apparently my GP and the surgeon did not - I had to explain it to them and request the support of a diabetes team.
Pre-op care for planned surgery should be done with the help and support of a knowledgeable team, there should be little need to cancel planned surgery because of high blood sugars if the diabetes specialist team is involved in planning the care. After all a blood sugar can be raised because someone is dehydrated, if the hospital is old fashioned and tells people to stop eating and drinking at 10pm the night before. A specialist team would know this, along with the knowledge that pre-op stress and not taking morning medications can also raise the BS.
All of this was dealt with by the hospital diabetes specialist team, after my GP talked with the surgeon and diabetes consultant. GPs are now taking the role of co-ordinating care, so they should all be highly aware of the NHS Diabetes document re improving standards in pre-op care for people with diabetes - as should we as the people with this condition.
.
After 50 years of integrating diabetes into my life and learning about its effects, plus years as a surgical ward sister, one thing I am sure about. Diabetes does not delay healing or prevent wounds from healing, prolonged high blood sugars do. If you have the help and support to keep blood sugars stable both before and after surgery you should be ok.
I hope this helps in obtaining the help and support you need,
Liz
thankyou all for comments,,, will have a look at above link and make sure im armed when i go for my pre op on 11th, my booking in time is at 11 so imagine op will be about 12 obv i need to know if to eat or drink or not if to take my tablet or not etc etc, its also a hour away from where i live but im going to br driven there as wont be able to drive afterwards. i so hope im not stuck over night waking up there on xmas on my own :cry: . x
