My six year old son who has had type 1 diabetes for just over three years is going to have to be circumcised at the end of the month. I am very nervous because he will have to be put to sleep but I think it will be day surgery only. He has a pre-admission appointment next week. I was just wondering what questions I should ask them to make sure they are planning on treating him correctly.

You should discuss this with your diabetes team and perhaps they can coordinate with the urologist and anesthesiologist. Key questions: how often will blood glucose levels be checked during pre, intra and post op course? Will sugar be provided intravenously? And how will insulin needs be managed? There are no set rules for these questions to be answered correctly but you will quickly understand if they have thought about them and have a reasonable plan by there answers. If you are uncomfortable with the answers, then postpone the procedure until you can coordinate care with the diabetes team. Postoperatively, the discomfort of the procedure itself coupled with less activity will likely require a bit more insulin but as long as you are carefully watching the blood glucose levels at home you should be able to make such adjustments much as you do for a sick day.

SB