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Produced by Diabetes Specialist Nursing Team/ Pre-Assessment Team
This leaflet will give you guidance on the importance of maintaining your blood glucose within normal level/ or optimum level prior and post-surgery. Your GP surgery will have performed a
regular blood test called a Hba1c or glycosated haemoglobin as part of your annual review; or maybe done more frequently depending on medication and your glucose control. It provides an
indication of your average glucose control in the 2-3 months before your Hba1c measurement was taken. It will be reported in mmol/mol and as a percentage.
Please be aware if your Hba1c is deemed as too high for surgery you may be removed from the operating list. You will then be asked to contact your GP surgery so they can assist you in maximising your treatment so your operation can then go ahead at a later stage. After surgery patients with uncontrolled blood glucose have a:
• a high risk of infection
• a slower healing process
• a prolonged stay in hospital than those who have a normal blood glucose level
Please inform your diabetes specialist Nurse (Nurse/GP/diabetes clinic) when you have been put forward for surgery, so they can support you with a plan with your medication prior to surgery and are able to monitor your blood glucose. Especially if you are having problems keeping your blood sugars within your normal range.
Monitoring blood sugars:
If you monitor your own blood glucose your diabetes care team may have suggested a range to keep your blood glucose level We would aim to run your blood glucose levels above 4mmols/l and
below 10mmols/l; by keeping your levels as close to this range as possible, most of the time, greatly reduces the risk of problems and complications.
Pre Assessment Clinic
The pre assessment nurse may have taken a blood test (or have your GP results) to check your HbA1c. (Glycosylated Haemoglobin) The pre assessment nurse will discuss your results and whether you can go ahead for surgery.
On the day of surgery
Remember to bring in:
• Your medication insulin /tablets/pens you take for your diabetes
• Blood glucose testing equipment (if you monitor your own blood glucose) and record book
• Treatment for hypo i.e. Glucose tablets or sugary drink plus a small carbohydrate snack – one of the following 2 biscuits, a cereal bar, slice of bread/toast.
If you have symptoms of low blood glucose or Hypo
If you recognise any of your signs of having low blood glucose or have any symptoms, such as sweating, dizziness, blurred vision, or shaking. Test your blood glucose if you are able to. If it less than 4 mmol/L take 4-5 glucose tablets or a sugary drink (half a standard sized can of non-diet cola or full sugar drink). Please tell the nursing staff at the hospital if you have taken a hypo treatment
because it is possible that your surgery may have to be re arranged for another day.
Your efforts before surgery can have a positive impact on your recovery after surgery:
• Discuss with the diabetes nurse should there be any significant changes in your health or levels of blood glucose. You may need to seek advice after surgery as you may require different dosing in
your medication or insulin after surgery
• Keep to a well-balanced healthy diet: Low in sugar and fat, high in fibre.
• Stop smoking: Smoking significantly increases the risk of developing problems associated with diabetes. Cardiovascular disease (heart disease, stroke and nerve damage and blindness) ref:
Continuing Professional Development:
Management of diabetes Module 4-minimising the impact of cardiovascular disease for people with diabetes.
• Exercise helps to reduce blood glucose levels. Even thirty minutes of walking a day is enough to improve your diabetes. This can be dependent on which operation you have had performed. Seek
advice before you leave hospital.
• Limit daily alcohol intake: No more than 2-3 units a day for women or 3-4 units for men. Try to have 2-3 alcohol free days each week.
Tel no: 0345 123 2399
If you have further questions regarding your operation please contact your diabetes nurse or GP.