Going to hospital
A hospital stay for surgery (operation)
Provided you and your health care team are adequately prepared, there is no reason why you should experience any problems with your diabetes during or after surgery. Talk to your doctor about the procedure and how it may affect your diabetes.
Where possible, appointments should be scheduled early in the morning, allowing for minimal disruption to your diabetes routine. Make sure you take something to eat after the appointment.
If you are required to fast for surgery, you will need to monitor your BGLs at least four times the day before. Your healthcare team will give you advice on adjusting your insulin.
Take all your medication with you to hospital, as well as information about required amounts and dosage times. BGLs within your target range in hospital will ensure better recovery. Make sure you note any required changes to your diabetes management when leaving the hospital.
Preparation is key to making sure your hospital visit goes as smoothly as possible. Pre-operative appointments are necessary to attend. At these appointments your care plans are finely tuned. The pre-operative staff will also answer all your questions and request necessary investigations that are needed prior to your admission to hospital (e.g. pathology, scans, xrays).
If your stay is planned, your healthcare team should have helped you prepare in advance but you may find it useful to ask the following additional questions to make sure you have all bases covered. The more prepared you are the more confident you will feel.
Useful questions to ask
Will I need to stop any medications prior to surgery?
Some medications such as Metformin, Jardiance or Forxiga may need to be stopped prior to hospital admission.
Do I need to adjust my insulin doses (particularly if fasting)?
You may need to take a reduced insulin dose or no insulin if you are going to be fasting. This will depend on the type of insulin being taken and the procedure being carried out.
Should I bring my diabetes medications with me to the hospital?
Yes, by bringing your medications / medication list to hospital your treating team can be fully informed on the medications you are taking. Usually at a pre-admission appointment you will receive full instructions regarding any medications you take for diabetes. Remember to take a list of all of your medications including any vitamins, herbal medications and over the counter medications you may be taking.
Will I be able to do my own insulin injections?
Some hospitals have strict policies regarding patients administering their own insulin in hospital. In some instances, a diabetes educator may be called in to assess your insulin injection technique before you are cleared to do your own injections. Mostly hospitals will use their own supplies of insulin and diabetes tablets. Hospital insulin is typically drawn up into a syringe unless safety needles are available for nursing staff to use.
Will I be able to stay on my insulin pump?
Sometimes you may be required to come off your insulin pump and your insulin needs will be taken care of by the hospital team via an intravenous drip. Check with your hospital as procedures regarding pumps vary between hospitals. If you are going to be using your pump in hospital it is a good idea to do a set change before admission. It is important however that you take all of your pump supplies, batteries and a list of your pump settings with you to hospital.
Should I be checking my blood glucose levels more often on the lead up to my hospital stay?
You may be required to monitor your blood glucose more frequently leading up to a hospital stay as the medical team will generally want your diabetes to be well managed prior to admission to reduce the risk of infections and slow wound healing.
How should I manage a hypo if I am fasting? Should I call the admissions team If I have a hypo during my fasting period?
Even if you are fasting you will need to treat a hypo which may occur. Check with your team if they have a preferred treatment method such as a glucose gel.
The team will need to be informed of any hypo treatment you have taken as this may mean a delay or cancellation of your surgery..
If in hospital during a hypo, tell the staff and you may be given glucose via a drip line directly into your blood.
For more information please see the surgery and hospital stays fact sheet.