What pre-surgery precautions should be taken for diabetic children?

Surgery should absolutely be done as the “first case”, especially if outpatient and elective. This makes management so much easier; patient or parent should demand same.
I advise morning long acting insulin at some decrease in dose depending on level of control. Less for better controlled and more for worse, to protect from hyper- and hypoglycemia later in the day.
I usually advise skipping the morning rapid acting insulin unless the patient is very hyperglycemic. Our day surgery has a protocol.
After day surgery, we arouse, offer clear liquids, and then advance. Most are on calories for supper and start back on some modified, but close to normal, routine.
For inpatient and long-term NPO [nothing allowed by mouth] surgery:…well, that’s why they invented IV insulin infusions.

LD
Additional comments from Dr. Quick:

Also, see Surgery Pre-Op Advice.

WWQ