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General Pre-Op for People With Diabetes

Your Care Instructions
Just because you have diabetes doesn't mean you can't have surgery if you need it. Surgery is safer now than ever before. But if you have diabetes, you may need to take extra care. Before your surgery, you may need to check your blood sugar more often. Your doctor may have you do this for at least 24 hours before and for 72 hours after your surgery. If you take insulin or other medicine for diabetes, your doctor will give you exact instructions about how to take them. It may not be the same as how you usually take them.

Following is what many doctors advise. But each person is different. If you don't get instructions about your medicines, ask your doctor what to do. And make sure to ask about anything you don't understand. If you take metformin, you may need to stop taking it 48 hours before surgery. And you may need to wait another 48 hours to start taking it again. If you take diabetes medicines other than insulin, you may need to stop taking them on the morning of the surgery. If you take short-acting insulin, you may need to stop taking it on the morning of the surgery.
If you take long-acting insulin, you may need to take only half of your usual dose on the morning of the surgery.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

Understand exactly what surgery is planned, along with the risks, benefits, and other options.
Tell your doctors ALL the medicines, vitamins, supplements, and herbal remedies you take. Some of these can increase the risk of bleeding or interact with anesthesia.

If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can. If you have an advance directive, let your doctor know. It may include a living will and a durable power of attorney for health care. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.
You will get exact instructions about when to stop eating before your surgery. It is important to have an empty stomach before surgery. But this can also lead to low blood sugar. Be sure to talk to your doctor more about this.
Check your blood sugar often in the hours before the surgery.

What happens on the day of surgery?

Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
Do not shave the surgical site yourself.
Take off all jewelry and piercings. And take out contact lenses, if you wear them.
At the hospital or surgery center
Bring a picture ID.

The area for surgery is often marked to make sure there are no errors.
You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.

Going home

Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.
If you control your blood sugar, it will help you get better faster. It will also lower your risk of infection.

When should you call your doctor?

You have questions or concerns.
You do not understand how to prepare for your surgery.
You become ill before surgery (such as fever, flu, or a cold).
You need to reschedule or have changed your mind about having the surgery.

Care instructions adapted under license by Alliance In Health Diabetes Control Center. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.

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