Question:
Management of diabetes pre, during and imediately after surgery.

I'm a type 2 diabetic with hypertension too, I'm on 2 meds for hypertension taken in the morning, and take avandia & glucophage in the morning, along with another glucophage in the evening. I'm wondering what I will need to do as far as altering my meds in the days just before surgery, I'm pretty sure I'll need to stop the glucophage. Also, what will be done the day of the surgery, the days in the hospital, and during the first few weeks? I assume that I'll need to be prepared for lots of extra testing, but what about hyper & hypo episodes, treating them, and what should I be prepared to do once home? Any help would be appreciated, and thanks in adavance!    — Sue F. (posted on July 1, 2001)

July 1, 2001
Sue, I am a Type II diabetic who was taking Actos every morning and Glucophage twice a day prior to my surgery. Keeping in mind that all physicians may take a slightly different approach, I was instructed to take all my medications (diabetic, blood pressure, diuretic) as usual right up until midnight the night before my surgery. The only exception to that was my anti-inflammatory medication which was held 3 days prior to surgery. On the morning of surgery, the pre-op nurse checked my blood sugar and the anesthesiologist ordered an insulin drip to regulate my blood sugar through the surgery and recovery room period. Post-op, the staff performed fingersticks four times a day and gave me insulin injections accordingly. Interestingly, I only required 2 insulin injections on the day of surgery. After that, all my capillary blood sugars that were done in the hospital were within normal range. On the day of discharge, two days post-op, I asked my surgeon when I should resume the Actos/Glucophage, and I was told that I wouldn't need them anymore. As a nurse, I was a little skeptical and continued to check my CBGs for the next couple of weeks at home. They were always normal, and have been for the past 15 months post-op. I had no hyper- or hypo- episodes at all and I have felt great ever since the surgery. I adhere to my surgeon's post-op dietary regimen - no sugars and limited fats - and I have lost 140 lbs, and am 10 pounds from goal. I can't say that this happens to EVERY diabetic patient, but my surgeon states that this is a fairly normal occurrence for most Type II diabetics. I will always have to list diabetes as part of my medical history, but now I can say that it is "controlled by diet". This has certainly been just another of the many miraculous blessings of this surgery. I wish the same wonderful experience for you!
   — Diana T.