While having diabetes puts you at a greater risk for complications during surgery, you can put a cap on these risks by being sure your diabetes is well controlled.
Even small changes in blood glucose levels make a big difference. If blood sugar is not well-managed, it raises risks for wound infections, which account for about two-thirds of post-operative problems with diabetes.
High blood sugar also increases the risk for stroke, cardiac arrest, lower limb ischaemia (a sharp decrease in blood flow to the legs and feet) and pressure sores — and may also result in a longer stay in intensive care.
If you need surgery right away, you may not have time to get your blood glucose under control beforehand.
But if there is time, here are five things you can do to improve your numbers:
1. Stay on top of blood sugar levels. It’s important to consistently and carefully measure your insulin levels to keep them under control.
2.Take all your medications. Be sure to follow your doctor’s advice about taking oral medications as well as injections.
3.Watch your waistline. You want to eat right and exercise consistently.
4. Consider seeing a diabetes specialist. Your doctor might recommend working with a diabetes specialist to help you get on track.
5. Don’t ignore other health conditions. If you have another condition besides diabetes, such as high blood pressure, high cholesterol or kidney disease, get those under control as much as possible. Each condition increases your risk for a poor outcome.
No matter what, be sure to talk with your doctor ahead of time about which surgical procedure is safest and best for you. You might explore minimally invasive surgery or bypass grafting, which often can provide better outcomes for patients with diabetes.
It’s also important to keep your blood sugar levels well in check after surgery. You’ll need to continue monitoring them regularly to avoid long-term complications that can come with diabetes and heart surgery.
If blood sugar isn’t well controlled after surgery, you’re more likely to have to go back in the hospital after your procedure. You’re also at a greater risk for neuropathy (nerve damage). Also, if your blood glucose is high before surgery, it often takes even more effort to control it afterward.
Working closely with your physician and managing your diabetes well before and after heart surgery is your best bet for good outcomes down the road.
Contributor: Faisal Bakaeen, MD