MDI Insulin Before Surgery

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MikeyBikey

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Type 1
I am shortly to have surgery. At a pre-op yesterday I was advised to sum the total units of Actrapid and Isophane I take first thing, devide by two, and to take this number of units as Isophane only first thing. Previously I have either been on a sliding scale already or only taken a correction dose if my BG was over 9.

Has anybody else been given this advice and how did it work out?
 
When I had surgery, I was not given any advice regarding my diabetes management.
I appreciate there is a concern about going hypo before or during surgery which can make a mess of the nil by mouth advice, hence the recommendation to reduce insulin,
However, I find the stress of the thought of the surgery makes my levels rise negating the risk of hypos so I stick with my usual insulin dose.

I have, thankfully, never had to endure the sliding scale and been responsible for my own insulin dosing. Ceding control of my insulin is one of my worst nightmares as I know we are all different and only I know how to manage my diabetes.
 
Tricky Helli, depends what it's surgery for and how long it's gonna take! At what juncture exactly does the BG object to its body being slashed open and parts of itself moved/removed?
 
That seems a strange formula. I don’t understand what the Actrapid has to do with it if you’re not eating. Surely it would depend on your ratio of isophane to Actrapid for the formula to work?
 
Some HCPs do seem to think basal:bolus should be 50:50. If you are more like 60:40, 40:60 or even further away it may not work too well.
 
My bolus is significantly more than my basal, so it wouldn’t work for me and could make me hypo. I’d be checking the advice was appropriate for me as an individual personally.
 
My ratio is 63/37. I am giving it a try today. Obviously I haven't eaten but I will be having a caffeine feed in place of a drop.

I think I will give myself a new pancreas today! I wish! Oh and a new leg!
 
Inka said:
I hope everything goes smoothly for you @MikeyBikey
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BG at 6:15 when insulin taken was 6.8. I will check every few hours today. Don't feel hungry so a caffeine infusion on the way! ☕

8:45 BG is 3.6 so not looking good. Will check again shortly to see if it stabilises or turns a corner. Obviously Einstein didn't come up with this formula!

9:30 Up to 5.2. Had to take 10gm CHO at 9:00 as perspiring profusely. Could have blown the operation if had happened on the day.

11:00 Up to 8.2

12:00 Stable at 8.2

15:00 Crept up slightly to 8.7

18:30 At 10.5.

With the hypo not a success so will try just my normal Isophane on Monday. Need a day or two to feed myself now!
 
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Had 2 surgeries, first on mdi was on sliding scale, bg levels stayed perfect throughout, other on pump & just left basal rate same but woke to higher bg levels, didn't want to increase rate as wasn't sure which way it would go.
 
helli said:
If you find a good Pancreas shop, please share ... the shop, not the pancreas 😎
Hope your "experiment" goes well today.
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Very fortunately there is less demand for legs! Matching would be tricky though. I can see the comments "I think that gentleman is diabetic". "Why do you think that". "Well he has got a white leg and a brown leg together with a brown eye and a green one. The eyes are quite appealing though!"
 
8:45 BG is 3.6 so not looking good. Will check again shortly to see if it stabilises or turns a corner. Obviously Einstein didn't come up with this formula!
 
9:30 Up to 5.2. Had to take 10gm CHO at 9:00 as perspiring profusely. Could have blown the operation if had happened on the day.

00 Up to 8.2

12:00 Stable at 8.2

15:00 Crept up slightly to 8.7

18:30 At 10.5.

With the hypo not a success so will try just my normal Isophane on Monday. Need a
 
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