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June 27, 2002

Surgery

Question from Southport, Merseyside, United Kingdom:

I am in my late 20s and have had many complications including neuropathy and retinopathy, my sugar levels can be quite erratic ranging from 5-18 mmol/L [90-324 mg/dl], and I am due to have a major hip operation in a few weeks. How I can assist speedy recovery from the hip operation I am due to undergo? What can I do pre and post operation to help keep my diabetes under good control?

Answer:

I would agree with you that good glucose control will deter infection and improve the quality of healing. How you go about doing that is not necessarily a clear issue. First, I would recommend you work with a healthcare provider who is enthusiastic about your intentions. Second, I would initiate a schedule of regular meals and meal content. Third, I would test frequently. This information could then be reviewed by you and your physician to regulate your sugars. I would also use an aggressive supplemental insulin schedule for sugars that are even minimally elevated.

Keep in mind that insulin requirements will be higher after surgery due to the pain and stress of the procedure. I would also talk to your physician about maintaining good control of your sugars surrounding your procedure in the hospital. This can be initiated with surgery and could include intravenous insulin therapy during your hospital stay.

JTL

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

WWQ]