Nutrition before surgery for patients with diabetes

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For diabetes, when surgery is very common complications. For the surgical process to have good results, it is necessary to have a suitable diet to control blood sugar before surgery. So what is the best thing for diabetics to eat before surgery?

1. Periodically test HbA1c to diagnose and monitor blood sugar stability before surgery

Patients with diabetes (diabetes) if not well controlled blood sugar, the risk of complications even death when undergoing surgery is very high. Preoperative factors should be carefully evaluated: type of diabetes and current treatment regimen, stable blood glucose status, organ complications. Stable glycemic control is a mandatory preoperative requirement for diabetic patients. To assess blood glucose status is usually based on intravenous blood sugar testing. However, blood sugar is very volatile due to many external factors such as pain or anxiety, fear...
Recently, recommendations suggest using HbA1c level as an important criterion for determining blood sugar levels. assessment of blood sugar stability. The HbA1c level reflects the blood glucose status of the previous 2-3 months and is therefore a much better estimate than another blood glucose value.
Before surgery, diabetic patients need to be consulted with an endocrinologist and anesthesiologist so that they can change the patient's current treatment regimen to suit the surgical requirements. If the patient's blood sugar is difficult to control with oral medication, insulin therapy can be switched. Blood glucose testing and HbA1c levels as criteria for assessing preoperative glycemic status are used by consensus recommendations. The best index goal is to maintain preoperative blood sugar between 6.67-10 mmol/L (120-180 mg/dL) and HbA1c <8.5 % (69 mmol/mol).

2. Diet for diabetics before surgery

In the treatment of diabetes, nutrition is an issue that has a great influence on health. Because it is necessary to ensure an adequate and balanced supply of both quantity and quality of nutritional ingredients to both control blood sugar, maintain desired weight, and ensure patient safety.
What diabetics eat before surgery has a great influence on the patient's health problem. Therefore, before surgery, you must have a nutritious diet to limit blood loss. Diabetics must have a therapeutic diet to reduce blood glucose and reduce acidosis to avoid possible complications such as: infection after surgery, slow wound healing, heart problems, etc. .. Most diabetic patients fast for one meal before surgery.

3. Some notes for diabetics before surgery

If you take Metformin, ask your doctor whether or not you should stop taking it. Usually, patients are advised by their doctor to stop taking metformin 48 hours before until 48 hours after surgery to reduce the risk of lactic acidosis.
If you are taking blood sugar-lowering agents of different classes to keep your blood sugar stable before surgery, it is recommended that they be discontinued 24 hours before surgery.
For patients treated with oral hypoglycemic agents
Blood sugar-lowering drugs are maintained until the day before surgery Fasting from the night before surgery Morning: do not eat breakfast and stop taking blood sugar-lowering drugs oral preoperative capillary glucose test to control blood glucose If capillary glucose is 4-12 mmol/l, no further intervention If glucose >12mmol/l, intravenous maintenance insulin therapy can be initiated , check capillary glucose every hour, before, during and after surgery until stable. Discontinue IV insulin when the patient resumes eating and resume oral hypoglycemic agents.

For insulin-using patients scheduled for morning surgery
Maintain insulin until the day before surgery Fasting from the night before surgery Morning: do not eat breakfast and stop fast insulin If the patient takes slow-acting insulin in the morning In the morning, half of the normal dose can be maintained. Check blood sugar (capillary glucose) before surgery so that if the capillary glucose is between 4-12 mmol/l and prognosis, the patient can eat again the same day and not fast. 2 meals, no need for additional intravenous insulin If glucose >12mmol/l, can start using insulin to maintain intravenous, check capillary glucose every hour, before, during and after surgery until stable. When the patient resumes eating, switch to subcutaneous insulin according to previous treatment. For insulin patients with afternoon surgery schedule
Maintain insulin until the day before surgery Fasting from the night before surgery Morning: can have a light breakfast with diabetic food and take a small meal. half daily dose of rapid insulin If the patient is taking morning slow-acting insulin, half the normal dose can be maintained. Capillary glucose check every 2 hours before surgery and every 1 hour during and after surgery. Continue treatment as patients with morning surgery. So, above are some notes to help you get more information to control blood sugar for people with diabetes. Patients with diabetes should pay attention to what to eat before surgery to reduce the risk of complications. If you have any questions, please contact your doctor immediately for timely support.
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