Information for all patients taking insulin who are admitted to hospital on day of surgery

Transcription

1 Information for all patients taking insulin who are admitted to hospital on day of surgery Exceptional healthcare, personally delivered

2 Introduction Many patients are now admitted to hospital on the day of their surgery. This includes people with diabetes providing: your diabetes is well controlled. you do not require regular admissions into hospital. you do not have significant complications from your diabetes. you do not suffer with frequent hypos & can recognise the symptoms. your general health is otherwise reasonable. you have a good understanding of your diabetic control. if you are planned for Day Case surgery and will return home the same day after your operation, you should be accompanied home by an adult who also understands the principles of your diabetic control. In addition to general advice for patients attending for surgery, here is some extra information to help you with your diabetes and to avoid your surgery being cancelled. If you have a continuous subcutaneous insulin pump please contact your nurse specialist or care provider for specific advice. Please ensure that you bring any supplies for the pump that you will need during your hospital stay. Please follow these instructions carefully. 2 Information for all patients taking insulin who are admitted on day of surgery

3 On the day BEFORE you are admitted to hospital: Unless told otherwise by your pre-assessment nurse, take all your usual medication including your usual insulin. Please eat your normal diet (unless given specific advice at pre-assessment). Before going to bed, eat a starchy snack particularly if you have hypos. NB if you are on Insulin glargine (Lantus) or detemir (Levemir), continue your normal dose even when fasting. On day of admission for surgery: Please bring your insulin and blood glucose meter with you to hospital. If your operation is scheduled for a morning list: Do not eat anything or drink milk after 2.30am. You may drink water or dilute squash until 6.30am. Do not take your morning diabetic tablets or insulin. If you usually take insulin glargine (Lantus) or detemir (Levemir) in the morning, you should continue this as normal. Check your blood sugar levels at least hourly. If your blood sugar level is less than 4 or you feel unwell (hypo), have a sugary drink, GlucoGel or glucose tablets to correct this. Please inform the nursing staff immediately when you arrive in the admissions unit. Information for all patients taking insulin who are admitted on day of surgery 3

4 If on an afternoon operating list: Check your blood sugar level on waking and at least 2 hourly when fasting. Have an early light breakfast before 7.30am. If you use short- or rapid-acting insulin, take half your normal morning dose. If you use pre-mixed or Isophane insulin, take one third of your normal dose. If you take insulin glargine (Lantus) or detemir (Levemir), continue your normal dose. Do not take any diabetic tablets on day of surgery. Do not eat anything or drink milk after 7.30am. You may continue to drink water or dilute squash until 11.30am. If your blood sugar level is less than 4 or you feel hypo, have a sugary, non fizzy drink, GlucoGel or glucose tablets to correct this. Please inform the nursing staff immediately when you arrive in the admissions unit. If you are planned for Day Case Surgery: When back home, continue to check your blood sugar every 2 4 hours until you go to bed. The stress of surgery may temporarily increase your sugar levels this is usually not a significant problem. Avoiding hypos is important. Take your normal insulin at the next scheduled time. Contact your GP or Out-of-hours service if you are vomiting or finding your blood sugar is difficult to control. You will receive a follow-up phone call from the Day Surgery Unit after your operation. 4 Information for all patients taking insulin who are admitted on day of surgery

5 Main points: 1. Follow instructions carefully to avoid your surgery being cancelled. 2. Take your usual insulin dose on the day before you are admitted for surgery. 3. Have a starchy bedtime snack on the night before surgery if you are concerned you may become hypo. 4. Please bring your insulin and blood glucose meter with you to hospital. 5. Monitor your blood sugar levels regularly until back on your normal regimen. If you are concerned or need further advice or information please contact the person who provides your care. (GP, practice nurse, Diabetes Specialist Nurse). Information for all patients taking insulin who are admitted on day of surgery 5

6 References and Further Information NHS Constitution. Information on your rights and responsibilities. Available at 6 Information for all patients taking insulin who are admitted on day of surgery

7 If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. This edition published August Review due August NBT002371