Managing Diabetes: Should Surgery Be Delayed for High Blood Sugar?

Diabetes mellitus

Hello Dr.
Ke: My mother is 63 years old and has had diabetes for seven years.
She has hard skin on her feet, and the orthopedic doctor suggested surgery to remove it.
However, my mother's blood sugar levels have been over 300 recently, which indicates she is feeling very fatigued.
Should we consider postponing the surgery? We would appreciate your assessment.

Ru, 30~39 year old female. Ask Date: 2001/05/03

Dr. Ke Zhengchang reply Internal Medicine

If surgery is not urgent, it is recommended to stabilize blood sugar levels before proceeding with the operation.

Reply Date: 2001/05/03

More Info

Managing diabetes effectively is crucial, especially when considering surgical procedures. In your mother's case, with a history of diabetes for seven years and current blood sugar levels consistently above 300 mg/dL, it is essential to evaluate her overall health status before proceeding with any surgical intervention.

1. Understanding the Risks of Surgery with High Blood Sugar:
High blood sugar levels can significantly increase the risks associated with surgery. Elevated glucose levels can lead to poor wound healing, increased risk of infections, and complications during and after the procedure. When blood sugar is not well controlled, the body’s ability to heal and recover is compromised. This is particularly concerning for surgeries involving the feet, as diabetes can already predispose individuals to complications such as infections and delayed healing.

2. Importance of Blood Sugar Control:
Before any surgical procedure, it is generally recommended that blood sugar levels be stabilized. For most individuals, a target HbA1c (glycated hemoglobin) level of less than 7% is ideal, but this can vary based on individual circumstances. In your mother's case, with blood sugar levels consistently over 300 mg/dL, it is advisable to delay surgery until her blood glucose levels are better controlled. This may involve adjustments in her diabetes management plan, including medication, dietary changes, and possibly increased physical activity.

3. Consultation with Healthcare Providers:
It is crucial to have a comprehensive discussion with her healthcare team, including her primary care physician, endocrinologist, and the orthopedic surgeon. They can provide insights into the risks associated with surgery at her current blood sugar levels and help formulate a plan to bring her glucose levels down. This may involve medication adjustments, dietary interventions, or even insulin therapy if she is not already using it.

4. Monitoring and Adjustments:
In the interim, closely monitoring her blood sugar levels is essential. Keeping a log of her daily readings can help her healthcare team make informed decisions about her treatment. If her blood sugar levels remain high despite adjustments, further investigations may be necessary to rule out other underlying issues, such as insulin resistance or medication side effects.

5. Lifestyle Modifications:
Encouraging lifestyle changes can also play a significant role in managing diabetes. A balanced diet rich in whole grains, lean proteins, healthy fats, and plenty of vegetables can help stabilize blood sugar levels. Regular physical activity, as tolerated, can also improve insulin sensitivity and overall health.

6. Conclusion:
In summary, it is advisable to delay surgery until your mother's blood sugar levels are better controlled. High blood sugar poses significant risks for surgical procedures, and ensuring her health is optimized will lead to better outcomes. Collaborate closely with her healthcare providers to develop a comprehensive plan that addresses her diabetes management and prepares her for surgery when the time is right. This proactive approach will not only enhance her surgical outcomes but also improve her overall quality of life.

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