Planning for an Elective Surgery and Have Diabetes?

In today’s world of expanding medical advances and technologies, many patients with diabetes find themselves electing to undergo a surgery or procedure that offers the promise of improving their current quality of life. Examples include joint arthroscopy, total joint replacement, spinal surgeries, and plastic or reconstructive procedures, just to name a few.

What you may not know, is that elevated blood glucoses can increase your risk of surgical complications. This can lead to risk of infection, poor or compromised wound healing, and lengthened recovery time (or even hospital readmission, in severe cases!). So before planning for an elective surgery, it is important to consider the following:

• Know your A1c! An A1c of 8.0% or higher is considered to be High Risk with respect to undergoing surgery, and can lead to a delay or postponement of your planned procedure. An optimal pre-surgery A1c value is in the 7.0% range or less, if you can achieve this without incurring significant hypoglycemia (low blood sugar). While there may be exceptions depending on your age and other comorbidities (health conditions), this is the general rule.

• Are you aware of your daily glucose trends? Whether you use a glucose meter or a CGM (Continuous Glucose Monitor), glucose values that are trending higher than target range of 80-180 mg/dl increase your risk of poor surgical recovery and impaired wound healing, including infection.

If you have an A1c higher than optimal range, and/or find that your glucoses are trending greater than target range, don’t despair! While you may need to delay the scheduling of your surgery or procedure for a short time in order to bring your diabetes management to the forefront, this doesn’t have to mean that you won’t be able to undergo this important surgery or procedure. Here are some recommendations for getting you in top shape for undergoing your desired surgery or procedure as soon as possible:

• Commit to making those lifestyle changes you may have been avoiding or postponing. This can be some low hanging fruit that is easier to “pick” than you think! Examples include: eliminating any sugary/sweetened beverages, saying no to fast food or sweets, reducing portions of meal or snack time carbohydrates, and getting more steps in each day.

• Schedule an appointment with your Primary Care Provider, Endocrinologist or with the Braden Diabetes Center to review your current diabetes medication regimen with respect to your current degree of glucose control and plans to undergo an elective surgery. It may be that changes to your diabetes medication or insulin regimen will be necessary to assist you in meeting your goals and getting you set up for your desired procedure as soon as possible!

• Be aware that you are in the driver’s seat and in control! The great thing about elective surgeries and procedures is that they are elective (meaning necessary but optional) and they are not usually time sensitive, versus emergency surgeries which are necessary to address a life threatening condition. This means that if it takes a few weeks or even a few months to get your diabetes in tip top shape, you do have the extra time it takes to make sure that things will go smoothly on the other end, ensuring a smooth and speedy recovery!

As always, if you have further questions or would like to speak with someone to get more or personalized information about this topic, don’t hesitate to call us at the Braden Diabetes Center at 1-415-925-7370. We are here to help you travel through life well with diabetes!