Diabetes and surgery
Having diabetes may mean you have more risk of problems after surgery. Your surgery will be planned carefully to help reduce the risks.
How surgery can affect your diabetes
Surgery is one of the main treatments for many cancers. The type of surgery you have, and how it may affect you, depends on the type of cancer.
Having diabetes may give you a higher risk of problems during and after surgery. For example, any surgical wounds you have may heal slower. You are also more likely to get a wound infection if your blood sugar level is not well managed.
Planning your operation
To help prevent problems, your operation is carefully planned. You will be closely monitored during and after it. You can reduce the risk of any problems by keeping your diabetes as well managed as possible in the weeks before your operation. Your diabetes team or GP can help you with this.
Before your operation, you will have an appointment at a pre-surgery assessment clinic. This is to talk about the plan for your care. Tell the nurse or doctor that you have diabetes and about any problems you have. Having surgery can be more risky if you have problems because of diabetes. This includes problems with your heart, eyes or kidneys.
If you have lost any feeling in your feet, your cancer doctor or GP may arrange some tests before your surgery. They will explain the tests and why you need them.
The nurse at the pre-surgery assessment will discuss managing your diabetes before your operation. They may also talk to your diabetes team. The advice they give will depend on how you manage your diabetes:
- If you take tablets, you may be asked to stop them for a short time before and after the operation.
- If you take drugs called SGLT2s, you will need to stop taking them 3 days before your surgery. These drugs include canagliflozin, dapagliflozin, empagliflozin and ertugliflozin.
- If you use insulin, you may need to change the dose. You should not stop taking insulin. If you use a pump or a continuous glucose monitor, your doctor, specialist nurse or diabetes team will explain how this will be managed.
Ask your doctors or specialist nurse for written information so you know exactly what to do and when. You may also speak to a pharmacist about your medicines.
The day of your operation
You are usually admitted to hospital on the morning of your operation. Sometimes you may be asked to go in the day before. This is so that the nurses can monitor your blood sugar level. They may also measure your ketone levels. Sometimes you may need to have a drip (infusion) of sugar and insulin to help keep your blood sugar level well managed.
The hospital team will give you information about eating and drinking on the day of your surgery. It is important to follow this information carefully. Where possible, they will try to make sure you are the first person on the operating list for that morning or afternoon. The hospital team will plan the best way to manage your diabetes when you are not eating. They will monitor your blood sugar level regularly. But it is still important to tell them straight away if you have any symptoms of low blood sugars.
After your operation
You should try to manage your diabetes again yourself as soon as possible after your operation. The hospital team will help you do this. You may have trouble managing your blood sugars at first. This may be because you:
- are not allowed to eat normally
- have less appetite
- are being sick
- are in pain
- are less active than normal
- feel stressed.
The nurses on the ward will check your blood sugar level regularly. You will not have to manage your diabetes yourself until you are well enough. When you are well enough, you can carry on being in charge of your diabetes unless there is a reason you cannot.
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Eating and drinking
Some people will be able to eat soon after their operation. For others, it may take longer. This depends on the type of operation you have. It will also depend on if you had the surgery under general or local anaesthetic.
Some people may have a drip of sugar and insulin until they can start eating and drinking again. Your doctor will tell you how soon you can start eating and drinking again. They will also tell you when you should start taking your usual diabetes medicines.
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Moving around
Getting up and about as soon as you can is helpful for your recovery. It can help reduce the risk of complications, such as developing a chest infection or blood clot. Being in bed for long periods of time increases the risk of a bedsore (pressure sore). Pressure sores are injury to the skin and tissue underneath. They are caused by pressure. The nurses will check your skin regularly and tell you how to reduce the risk of any problems.
Moving around can also help to lower your blood sugar. The ward staff will help you if you need support in getting up and moving.
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Risk of infectionIf your diabetes is not well managed, you are more at risk of developing an infection. Tell your nurse or doctor straight away if your wound becomes hot, painful or starts to bleed or leak any fluids. Tell them straight away if this happens when you go home.
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Your wound
Any stitches, clips or staples in your wound are usually taken out 7 to 10 days after the operation. Or you may have dissolving stitches. The wound may take longer to heal if your blood sugar level is not well managed. The practice nurse at your GP surgery can remove any stitches. Or the ward nurses can arrange a district nurse to visit you if you cannot get out of the house.
Date reviewed
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