Diabetic patients often have comorbidities that require surgery, such as cataracts, foot ulcers, cholecystitis, or coronary artery disease, among others. Diabetic patients can undergo surgery just like normal individuals, but surgery causes changes in the body’s homeostasis, with the secretion of various hormones that affect blood sugar control and subsequently impact wound healing and infection.
Therefore, before undergoing surgery, patients should have their blood sugar controlled to normal or near-normal levels. Sometimes, doctors may need to postpone the surgery until the patient can control their blood sugar well.
In emergency surgery cases, if necessary, surgery can be performed immediately, but patients are at risk of complications during surgery, such as abnormally low or high blood sugar levels.
For diabetic patients who have good blood sugar control, after surgery, once the patient enters the recovery phase and the wound has healed well, those who previously took oral diabetes medication can continue taking the medication and do not necessarily have to use insulin injections permanently.
Guidelines During Surgery for Diabetic Patients
Patients need to fast from food and water to control blood sugar levels before surgery, which helps reduce fluctuations in blood sugar levels and lowers the risk of complications during surgery.
Although diabetic patients have a somewhat higher risk during surgery compared to the general population, if properly managed from the preoperative to postoperative stages, the risk of complications or harm is not significant.
Therefore, patients should take medications or insulin injections as prescribed continuously and bring their medications when receiving treatment at the hospital. Usually, doctors will advise stopping oral hypoglycemic agents 24 hours before surgery or when fasting begins. The doctor will consider the patient’s blood sugar levels and diabetes control.
What Diabetic Patients Should Be Careful About After Surgery
- Blood sugar levels that are higher or lower than normal
- Poor or slow wound healing; weakened skin or tissue around the surgical site
- Infections, including wound infections, pneumonia, urinary tract infections, and bloodstream infections
- Development of diabetic ketoacidosis (DKA)
- Significant increases or decreases in electrolyte levels (sodium, potassium), which may cause heart problems and fluid balance issues in the body
All these precautions will be closely monitored by the medical team after surgery, and patients will be advised on how to observe, prevent, and recognize when to urgently see a doctor during home recovery.
