I a 24 year old full time graduate student, have type 1 diabetes treated with an insulin pump, and although my blood sugar levels are not under tight control right now, my diabetes team is working with me to get them under tighter control. For about five years, I have had tonsillitis about twice a year and was hoping to have a tonsillectomy prior to the start of the academic year.

My previous diabetes doctor always advised me against the surgery, and while I have not spoken to my current doctor I plan to do soon. Is this a surgery older people with diabetes should avoid? My main concern is that I have a lot of low blood sugar readings. I know they will be able to monitor my levels while under an anesthetic, but how do they monitor it? Do they continuously check my blood sugar levels? Any advice you can give would be appreciated!

If this is an elective surgery, I would suggest optimizing your blood sugar control prior to surgery. It will make the recovery period easier to tolerate. If you do not have good control now, it sounds like you need to do that. The sugars will be labile and more difficult to control for one to two weeks following surgery. Good control is better for healing, avoiding infection, and keeping your strength up.

I do not think that this surgery is any worse than other forms of “minor” surgery people with type 1 diabetes have to contend with. As far as surgery goes, you will need pre- and intra-operative blood sugar monitoring. The anesthesiologists usually do this, but it is a good idea to do this in conjunction with your diabetes care physician. The insulin pump can be used intra-operatively. However, the conditions for its use need to be spelled out clearly and agreed upon by the anesthesiologists and the diabetes physician.

JTL

[Editor’s comment: Also see Surgery Pre-Op Advice, at the Diabetes Monitor, for some additional thoughts.

SS]