Advice please

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Rachie B

Rachie B

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Relationship to Diabetes
Type 1
Hi all, and thank you in advance for taking the time to read this.
So, I am scheduled for a hip replacement this Friday and I'm really anxious about the procedure, but more so about keeping the diabetes under control (I'm a new type 1) I have been told to reduce my lantus by 20% and eat nothing from midnight Thursday. My worry is, I get 'foot on the floor'..I may wake up with a good number between 5 and 8 usually, but as soon as I start moving, it shoots up. I usually give myself and unit or two (fiasp) to stop the rise if I'm not eating for a little while. I guess I won't be allowed to do this. My question is, do I let the rise happen and hope it just comes down by itself? I worry that my blood sugar will be too high for surgery, but also I worry that I will be too low for it as well! I'm just worried, as you all know this stuff is so unpredictable. Aghhh!
Also has anyone had any experiences with anaesthetics and surgery?, I think I can have a general or a spinal.
Thanks so much
 
I don't see why you couldn't take a unit or two of fiasp if that's what you usually do and you're pretty confident you won't go hypo. (Have some dextrose tablets handy just in case you do need to eat. I think they're not likely to cause any issue (though mention them just in case if you do have to eat any).)

Overall, though, I'd advise trying not to worry too much: they'll have operated on people with Type 1 before and they'll have procedures to follow to keep you well enough controlled while you're not able to do it.
 
Hi.
If it was me, I would still use the Fiasp in the morning if that is your usual routine (I employ the same strategy with Fiasp and Foot on the Floor and my levels would soon be in double figures without it.
When do you do the Lantus reduction? If it is the night before then you are more than likely going to need that Fiasp more than usual, so I think you will be pretty safe to do it. I tend to inject it as soon as I wake up, before I get out of bed, so by the time you go for surgery the chances are that it will no longer be active. I think it is likely that your levels will go high due to stress and the reduced Lantus so I doubt you will have much worry about a hypo but the odd glucose tablet if necessary to treat a hypo is not really going to impact your fast for the operation if you need them but do let the medics know if you do have to take some and chew them well so that it absorbs mostly in the mouth if you do need to treat a hypo.

Do you have a time for your surgery or is it just a question of turn up on the day and wait until they wheel you into theatre?

Good luck and I hope it all goes very smoothly. Do you have Freestyle Libre to monitor your levels?
 
rebrascora said:
Hi.
If it was me, I would still use the Fiasp in the morning if that is your usual routine (I employ the same strategy with Fiasp and Foot on the Floor and my levels would soon be in double figures without it.
When do you do the Lantus reduction? If it is the night before then you are more than likely going to need that Fiasp more than usual, so I think you will be pretty safe to do it. I tend to inject it as soon as I wake up, before I get out of bed, so by the time you go for surgery the chances are that it will no longer be active. I think it is likely that your levels will go high due to stress and the reduced Lantus so I doubt you will have much worry about a hypo but the odd glucose tablet if necessary to treat a hypo is not really going to impact your fast for the operation if you need them but do let the medics know if you do have to take some and chew them well so that it absorbs mostly in the mouth if you do need to treat a hypo.

Do you have a time for your surgery or is it just a question of turn up on the day and wait until they wheel you into theatre?

Good luck and I hope it all goes very smoothly. Do you have Freestyle Libre to monitor your levels?
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Thank you x yes I have the libre. I have to be there for 7.30 and I think they get me in first so that's something at least. I usually take lantus in the morning, about 8, so I guess I'll take it before I leave at 6.45.
 
Rachie B said:
Thank you x yes I have the libre. I have to be there for 7.30 and I think they get me in first so that's something at least. I usually take lantus in the morning, about 8, so I guess I'll take it before I leave at 6.45.
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In that case, unless your waking levels are high, I would err on the side of caution and have just 1-1.5 units of Fiasp. You can always do another correction later if you find your levels drifting upwards and you end up lower down on the theatre list than you anticipate..... assuming they don't take your insulin off you in the hospital which unfortunately does happen to some people.
 
Rachie B said:
Thank you x yes I have the libre. I have to be there for 7.30 and I think they get me in first so that's something at least. I usually take lantus in the morning, about 8, so I guess I'll take it before I leave at 6.45.
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Are they going to put you on a sliding scale for the op @Rachie B ? I don’t know how long such an operation takes.
 
Rachie B said:
What do you mean a sliding scale? I think the op is about 2 hours, but I'm not too sure
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An insulin (and glucose often) drip that they adjust depending on your blood sugar. That way they can keep the person’s blood sugar in range during surgery.
 
If you take your Fiasp, make sure they know you’ve taken it. When I had an op a couple of years ago, I was told to reduce my basal the night before and not take any rapid insulin that morning (it was a morning op). (This was all written down and discussed in my pre-op appointment, btw).
 
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