Those of us living with diabetes may often think of the disease as our main health concern. But having diabetes doesn’t mean other health concerns won’t arise. I’ve discovered that if you’re living with diabetes and heading to the hospital for a procedure, there are some things to keep in mind that may help to better prepare yourself and your diabetes health care team.
For some procedures – including those that require anesthesia – you may need to fast (not eat or drink for up to twelve hours prior to the procedure). If fasting is required, it is ideal for someone living with diabetes to be scheduled as early as possible in the morning, because not eating for an extended period of time can lead to either low or high blood sugar levels. It is a great idea to check your blood glucose more frequently both the night before and day of the procedure and make a plan with your health care team about what to do if your blood glucose is running high or low while you are fasting.
Fasting may also require making changes to your medication, though not necessarily. Ask your health care provider about what to do with your medication(s) the evening before and day of the procedure.
The effect of stress
Another factor to consider when going to the hospital is stress. As a nurse, I know that going to the hospital for a procedure can be stressful, and stress may affect blood sugar. So I believe stress levels are something to pay attention to and bring to your doctor’s attention, if necessary.
Ask both your diabetes health care provider and your surgeon to discuss a plan for your diabetes care prior to the procedure. I think it’s a good idea to bring extra of whatever diabetes supplies you normally use. What if you wear an insulin pump? In some hospitals, you may be required to remove your pump for the procedure, though more healthcare facilities are becoming comfortable with having patients keep their pumps on during surgery. Be sure to pack extra pump supplies in case you need to change your set at the hospital.
As medication levels may change while you are admitted, it’s important to ask about a plan or schedule for resuming any medications that were stopped while in the hospital. If anything is not clear to you, contact your health care provider for clarification and guidance.
What about food? As mentioned, you may not be eating anything for several hours before the procedure. Once you are able to eat, you may be given a hospital meal tray, or you may be back at home. How much and what types of food you eat will depend on how you are feeling and the instructions given by your health care team. Make sure the nursing staff is aware that you are living with diabetes before selecting your meal. If you are staying in the hospital, ask if there is a registered dietitian (RD) on staff who will be able to consult with you and help plan your meals.
Communicating with health care providers is crucial to a smooth and successful procedure, especially for those living with diabetes. Some hospitals even have staff members devoted to working with people who are preparing for hospital procedures – something you can inquire about ahead of time. You might even experience less stress if you are well-informed and confident right from the beginning, and ensure all members of your health care team are on board with your diabetes needs.
Jane K. Dickinson is a nurse and certified diabetes educator who has lived with type 1 diabetes since 1975. Jane lives in Steamboat Springs, Colorado, where she provides diabetes education to community members and health care providers. She is currently the program coordinator and faculty for the Diabetes Education and Management Masters Program at Teachers College Columbia University. Jane has published two books: People With Diabetes Can Eat Anything and Diabetes Karma. Jane writes about everyday topics and how they relate to diabetes on her blog at www.janekdickinson.com. In her spare time, Jane loves to walk, travel, listen to music, watch movies, and spend time with her husband and two children. Dickinson is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.
© 2013 The DX: The Diabetes Experience