My mother was diagnosed with diabetes 6 months ago and does not use insulin. She needs surgery for a painful condition unrelated to the diabetes, which prevents her from walking. Does the diabetes increase the risks of surgery?

Question

My mother was diagnosed with diabetes 6 months ago and does not use insulin. She needs surgery for a painful condition unrelated to the diabetes, which prevents her from walking. Does the diabetes increase the risks of surgery?

Answer

We do not know her diagnosis, but it would seem that your mother definitely requires her operation. The point about surgery is that the anaesthesia provokes a stress response, but these effects can be avoided with spinal anaesthesia, and therefore it would depend on what sort of anaesthetic your mother is going to have.

Surgery itself is known to cause a major metabolic change, which often increases blood sugar, and this may require insulin for a short time to bring it back to normal levels. Often patients are admitted to hospital for 2 or 3 days before the operation to gain optimal control of their diabetes. Because food is omitted during the operation procedure, an intravenous drip will often be put up and an infusion of glucose and perhaps insulin and potassium will be given. After the operation, there will be a careful check on the potassium and glucose levels in the blood. If your mother does not take any diabetic tablets, then management is often very similar to that for non-diabetics, and indeed if she does take diabetic tablets, then all that is necessary may be for her to omit the tablets on the day of the operation.

Overall, we feel that you need have no worry about the operation per se because your mother is diabetic. In any reasonable hospital, the care of her diabetes will be paramount to the doctors and there should be no increased risk. She will of course require careful monitoring, and we are sure that the doctors doing so will provide the appropriate treatment should she need it.

Links

• American Diabetes Association

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• Conflicting Results on Diabetes Control