Diabetes Preoperative Care

Operation

Diabetes Planned Surgery Service

Patients who attend Erme ward and Orthopaedics outpatient pre assessment areas are referred to our team for support via set criteria.

Referral Criteria

  • All patients on Insulin.
  • Anyone with a HbA1c of >75mmol/mol (9%).  (Sub optimal diabetes for surgery).
  • Repeated hypoglycaemia (blood glucose less than 4mmol).
  • Total pancreatectomy.

 

Patients are assessed either in person or via a telephone consultation and pre-operative and postoperative medication advice is provided. If you have any concerns regarding the medication leaflet advice please contact the Diabetes Centre. A summary of the diabetes day of surgery plan is placed into the notes.

If the diabetes blood glucose control is sub optimal we request that patients test their blood glucose before meals and before bed or less as needed and although weight loss, exercise and dietary changes would be the first option sometimes time is an issue. If the operation is needed sooner rather than later and pre booked, the clinical need for the operation always comes first and it is not our decision to cancel any operations. However, if the operation is not urgent then by improving the diabetes prior to surgery can help to reduce the risks for anaesthetic, wound healing and complications post operatively.

We aim to improve communication across the multidisciplinary team involved with your surgery. We liaise with the surgeon and anaesthetist as needed and also your GP/ Practice nurse so that follow up is in place post operatively as needed.

We try to see you on the day of surgery. If you have a planned inpatient stay then we will follow you up on the ward as required, so your discharge is not delayed due to diabetes.

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