July 18, 2000
Surgery
Question from :
My six year old son has had type 1 diabetes for 6 months. He has had chronic ear and sinus infections since then, with the diagnosis that his adenoids and tonsils need to be removed due to their large size and the blockage they are causing. I need to make a decision regarding this surgery, and feel it is made tougher by the fact he has diabetes. I am concerned about the effects on his diabetes, effective monitoring of his blood-glucose during surgery, not being able to eat his required carb diet following surgery. I would appreciate any input or information about this surgery and, in particular, this surgery preformed on children with diabetes. The surgery is still our decision, but we are being advised that by not having it done he will continue to get infections that affect his diabetes as well as hearing loss due to the ear infections. I am so scared to make a move on this, and can not seem to make a decision, feeling like our situation is different.
Answer:
I would suggest following the direction of your physician regarding the need for a tonsillectomy and adenoidectomy. I would also suggest discussing this at length with your diabetes team. You will be able to manage his diabetes after the surgery despite your son not being able to take in food well. Your diabetes team may suggest replacing his diet with fluids that will adequately replace his carbohydrates and nutrition temporarily after the surgery. I would also aim to keep him in a nearly normal range immediately after the surgery — but not focus on extremely tight control of blood sugars in the few days after the surgery. In other words, be creative with his diet and insulin dosing to best meet his needs while still proceeding with the surgery.
MSB
