3 Things to Know About Managing Blood Sugars For Surgery

Whether going through a major surgery or a same-day operation, changes to your diabetes management plan are usually necessary. Based on my experience as a Certified Diabetes Care and Education Specialist (CDCES), here are some things to expect and questions you can ask to help prepare you for surgery.

1. Medication adjustments

If you take diabetes medication, there's likely a good chance your surgery team will tell you to lower your dose or stop the medicine before the surgery, usually the morning of the surgery or the night before.

Some of these changes will prevent low blood sugars, which is a risk if you take sulfonylureas (glipizide, glyburide, etc.) or insulin. Other reasons for medicine adjustments are related to kidney function. The kidneys can sometimes struggle to work properly after specific procedures or surgeries. Medicines like Metformin and SGLT-2 inhibitors (Jardiance, Invokana, etc.) should be used with caution if you're dehydrated or your kidneys need time to recover after surgery.^1,2

Other questions to ask your healthcare team

• Here is a list of my current medicines. What changes do I need to make before and after surgery?
• Am I going to be on any new medicines after surgery that could raise or lower my blood sugar? For how long?
• After surgery, who can I call if I have questions about my diabetes medicines?

2. Nutrition and meal changes

Changes in eating patterns can be tricky. Before and after surgery, eating solid foods is usually off-limits. Drinking clear liquids is generally recommended.

Over the few days after surgery, your eating plan is often changed back to regular meals. Make sure to have both sugary and non-sugary options for clear liquids. Depending on what medicine you take and if changes were made to them, you may need clear liquids with sugar to treat low blood sugar or to replace the carbohydrates you would usually get from a meal.²

Examples of clear sugary liquids are apple juice, 7-Up, Gatorade, and Jell-O. Otherwise, sticking to non-sugary drinks can help keep blood sugars in a healthier range. Examples of non-sugary clear liquids are tea, coffee, water, or broth.

Other questions to ask your healthcare team

• What can I use to treat a drop in my blood sugar if I'm not supposed to eat before surgery?

3. Closely monitoring blood sugar

Before and after surgery, you'll need to monitor your blood sugars more often. Chances are you'll see more highs or lows in your blood sugars. Changes to your diabetes medicines, taking a new medicine, eating patterns, stress, and changes in sleep and activity affect your blood sugar. If you wear an insulin pump or a continuous glucose monitor (CGM), you may have to take it off during surgery, making managing your blood sugars harder.²

Other questions to ask your healthcare team

• How often do I need to be checking my blood sugar?
• What range should my blood sugars be in after surgery?
• Who should I call about my blood sugar levels after surgery?

Changes to your diabetes care can be complex, even if necessary (like in the case of surgery). Asking questions and being prepared can help you learn what to expect. It'll help you keep your blood sugars in healthier ranges, which is essential in helping you heal after surgery. And finally, it'll offer guidelines on what's not normal and when to call your doctor.