Managing your Diabetes Before and After your Day Surgery ...



Managing your Diabetes Before and After your Day Surgery Operation.

Please alter your medication as instructed below. Also, please see the medication charts attached for further information.

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If your operation is in the morning:

• Do not eat any food after midnight

• Drink water up until 6am

If your operation is in the afternoon

• Eat breakfast before 7am, but eat nothing after this time

• You can drink water up until 11am

• Please bring some glucose tablets or a sugary drink to the hospital with you

If you have any symptoms of a low blood sugar, such as sweating, dizziness or shaking, please check your blood sugar if you are able to do so. If it is less than 4mmol/l take 4 glucose tablets or 150mls of a sugary drink.

Please let the nursing staff know you have done this, as we may need to rearrange your operation.

• After your operation your blood sugar will be checked

• You will be offered food and drink when you feel able to eat.

• If your operation is in the morning and you are eating and drinking normally by the afternoon you may be able to resume your normal evening tablets and/or insulin

• If your operation is in the afternoon, you should resume taking your normal tablets and/or insulin the next morning if you are eating and drinking normally. Your blood sugar may be higher than usual for a day or two.

If you are unwell when you get home, are nauseated or vomiting or unable to eat:

• DO NOT stop taking your insulin or tablets-illness can increase your body’s need for insulin

• Test your blood glucose level every 2 hours

• Test your urine for ketones every time you go to the toilet

• Drink at least 100mls water/sugar free fluid every hour

• Rest

• Eat as normally as you can. If you can’t, replace solid food with one of

o 400ml milk

o 200ml fruit juice

o 150-200ml non-diet fizzy drink

o 1 scoop ice cream

If you:

• Have continuous diaarhoea or vomiting

• Are unable to keep fluid down for more than 4 hours

• Have high glucose levels with symptoms of illness (above 15mmol/l)

• Ketones at ++2 or +++3 in your urine or 1.5 mmol/l in blood

Contact your GP or diabetes specialist nurse immediately. Out of hours consult the local out of hours service or A and E.

How to adapt your diabetic tablets or non-insulin medication

|Tablets |Day before op |Day of surgery |Day of surgery |

| | |Morning operation |Afternoon operation |

|Acarbose |Take as normal |Omit morning dose |Take morning dose with |

| | | |breakfast. Omit lunchtime dose. |

|Meglitinide |Take as normal |Omit morning dose |Take morning dose with |

| | | |breakfast. Omit lunchtime dose. |

|Metformin |Take as normal |If take once or twice per day do|If take once or twice per day do|

|If contrast media is to be used | |not stop. If three times daily, |not stop. If three times daily, |

|and eGFR ................
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