My seven year old son, diagnosed with type 1 diabetes about 22 months ago and in tight control, may need his tonsils out, due to excessive snoring. We are going in for a follow up to evaluate his condition further, but I am wondering what the complications of anesthesia are, if any, for child with diabetes. What about giving insulin, and eating? What should I be aware of?

I do not believe that having a tonsillectomy is any bigger concern in a child with well-controlled diabetes than in a child who does not have diabetes. Your question about eating and insulin is a good one, and one that your son’s diabetes team will want to address.

Depending on the types of insulin your son usually receives, the doses will need to be modified. We usually prefer that such patients be the first case of the day. Usually, any short-acting insulin (Regular, Humalog, or Novolog) is significantly decreased or held the morning of surgery. The longer acting Ultralente or Lantus (insulin glargine) may not have to be decreased for surgery, but NPH or Lente may need to be decreased slightly. Your child’s diabetes doctor should make the call.

DS

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

SS]