High Glucose & Surgery

Men, I've already shared my woes on the doc changing my diabetes medicine (probably because I had an higher 3 month avg.) and the new med just sky rocketed my glucose level up to the high 200's into the 300s all day. I've changed myself back to Avandia about 4 days ago and should be getting some results in a few days of lower numbers hopefully, however, my wife tells me that Avandia starts petering out of control in 5 years of taking it. My question:  Do I have to get this  under control before going under the knife, in my mind I would hate to have surgery while my glucose level is 350 (heart attack) level maybe.  I'll ask the doc because I've got the stupid chemical stress test tomorrow along with the internist meeting and pul....test on my legs. Thanks, Bob.

Bob, Wow, I do not have any good advice, but it sounds like your having your own form of stress test with all these issues piling up prior to your big day. I hope all goes well with your testing and that your return to Avandia can get you back into line with the pre-WLS guidelines. Hopefully, after the WLS, the need for  Avandia will fade away and the stress will be able to dissipate with new energy and exercise. Herb

I got yelled at by my surgeon pre-op consult because I stupidly ate stuff a couple hours before my admission tests. My sugars were about 300, and he said if they were above 150 the morning of surgery, I'd be going home that same day.

I told him exactly why they were high, and I'd have them in line on Knife Day. When I did my 24 hour liquid diet, I ate so much sugar free jello that I'm now forever scarred, but my level was 110.

Can you talk your doc into getting you some Actos in the short term? That stuff will bring your glocuse down FAST, and (at least my surgeon) was concerned about my level going in; coming out would take care of itself...

Bob - Although as a type 2 I've always tried to avoid insulin, when I was in the hospital, they did end up using it when I "spiked" to help bring my sugar down; you might need to end up going on it for a short while to counteract the high sugars and bring them into a normal range. With your sugars high, you're a lot more prone to infection and your healing will be slowed way down... so it really is a good thing to get it under control.. If that means shots for a few days or weeks until you can get surgery or get it back into control, then it's a small tradeoff... Since my surgery, I haven't needed any pills or insulin; my A1C has been below 6 the times I've measured it, and my fasting glucoses are usually < 80. I do end up still spiking sometimes if I get into the carbs at the 2 hour post prandial "spot check", but it usually ends up coming right back down again. Best of luck with whatever you and your doctors decide & hang in there - ...Nick

We routinely cancel people's surgery (any procedure you can imagine) for high blood sugar. 300 is very high for surgery I think they want it at around 150, 200 max during surgery. We usually hit them with a dose of insulin if they take it and go from there.

Sorry, No info there Dan…. I do know that they want it "in line" before surgery. Are you modifying your diet yet pre-op? I have only second-hand Diabetes info from my dad and those I’ve read out here. Do what ever you can to get your Blood Sugar levels under control. I’d say, go after it with low-glycemic foods as well as the meds… but, I don’t know if others have found that to be completely helpful advice… Hope it all settles down for you soon. Best Wishes- Dx

Bob, I was in the exact same boat with high blood glucose in the pre-surgery period. I am a patient at the Joslin clinic here in Boston and I decided with them to be as aggressive as possible in getting the blood glucose under control. We did this by using Lantus for basal insulin, NovoLog for mealtime insulin and Januvia to restore insulin-secreting cell function. However, a cornerstone was careful dietary monitoring.

This did an excellent job in controlling things in a short time. I went from an A1C of 9 to 5.5 within 3 months (5.5. right before surgery). I am very glad I did this and I encourage you to also get aggressive as it help tremendously with surgery and recovery.

Let me know if I can help in any way.

Hey Nate! Great to see you posting! So? Two weeks out now…How ya doin.? You’re just pulling out of the roughest part for most folks. Hope all is going well! Jump on in with questions or thoughts! Glad to have you here. Best Wishes- Dx

 

Thanks! Doing pretty well actually. Just making sure the fluids and protein are on track. Glad to be here.