Notes in blood sugar control before surgery

Diabetes is a disorder of glucose metabolism caused by relative or absolute deficiency of insulin. This is a common chronic disease, the prevalence of diabetes is about 7%. There are two types of diabetes:
type 1 diabetes: insulin dependent type 2 diabetes: non-insulin dependent diabetes Diabetic patients have an increased risk of infection after surgery and an increased risk of developing diabetes. cardiac complications after surgery. Therefore, blood sugar control before surgery is very important to prevent possible complications.

The goal of preoperative glycemic control is to prevent severe hyperglycemia or hypoglycemia in the perioperative period. Measure serum electrolyte levels of all diabetic patients and treat before surgery. In addition, renal function should be assessed by measuring BUN and serum creatinine levels.
During surgery, specific drug management depends on several factors including:
Type of diabetes Type of surgery Length of surgery For patients who do not need insulin during surgery Blood sugar should be monitored to prevent hypoglycemia and ensure prompt treatment of severe hyperglycemia. For patients requiring insulin during surgery, intravenous insulin is better than subcutaneous insulin, has a fast onset of action, a short duration of action, and is easy to titrate. Alternatively, intravenous insulin can be continued in the postoperative period until the patient is able to eat.

For diabetics using insulin
Patients undergoing any surgery. Patients who are taking insulin undergoing any surgery. Patients who are taking oral medications, undergoing major surgery.

For patients with diabetes who do not need insulin
Diet control undergoing any surgery. Insulin-dependent patients well controlled by oral medications undergo minor surgery requiring general anesthesia or spinal anaesthesia. Minor surgery: Procedures such as transurethral prostatectomy and laparoscopic surgery. Major surgery: thoracotomy, laparotomy, sternotomy, vascular surgery.

Check blood sugar regularly. Often, blood sugar levels after surgery are difficult to control because:
Change in eating habits Vomiting Stress after surgery Less activity than usual Usually, it takes longer for people with diabetes to recover compared to those without diabetes. Therefore, if you have to undergo major surgery, you will need to be hospitalized. Patients with diabetes usually stay in the hospital longer than those without diabetes. Patients should be monitored for complications such as:
Infection: Signs of infection such as fever, or the incision site is red, hot, or oozing pus. Ulcers: due to lying down for a long time. To avoid the need to often turn around in bed, if possible, get up and move around gently. Some patients lose sensation in their toes or fingers due to diabetes, and will not feel the pain caused by the sores.

In summary, diabetes is a common metabolic disorder. If the patient has to undergo surgery, it is important to control blood sugar before surgery, in order to prevent complications caused by diabetes, especially low blood sugar during surgery and increased blood sugar levels. risk of cardiac complications after surgery. In addition, after surgery, patients need to be monitored for signs of common complications such as ulcers, infections,...
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