Peri-operative medicine
Instructions for patients with diabetes undergoing surgery or procedures requiring starvation.
Please bring this leaflet with you for your admission.
Please read this information carefully and follow the instructions below.
If your admission time is in the morning – before 10.30am
Do
Do drink clear fluids such as water, black tea or coffee (without milk) or sugar free squash or still cordial up to two hours before your admission time
Don’t
Don’t eat any food after midnight the night before
If your admission time is after 10.30am or later
- Eat a light breakfast before 7am, eat no further food after this time
- Drink clear fluids such as water, black tea or coffee (without milk) or sugar free squash or still cordial up to two hours before your admission time
Instructions for taking your diabetes medication and, or insulin
| Medication and usual dose | Day prior to admission | Day of surgery Admission before 10.30am Morning Dose | Day of surgery 10.30am or later Morning Dose | Noon Dose |
|---|---|---|---|---|
| 1. | ||||
| 2. | ||||
| 3. | ||||
| 4. |
Please take all other medications as normal on the day of surgery unless you have been instructed otherwise. Do not chew gum for at least two hours before your admission.
Please bring all equipment to administer your insulin or other medication and monitor your blood glucose with you.
| Signature: |
| Name: |
| NMC: |
| Date: | Time: |
Other important information
Please carry glucose tablets or a sugary drink with you when you travel to and from the hospital.
Your blood sugar will be checked on arrival at the hospital.
If you feel unwell or have any symptoms of low blood sugar such as sweating, dizziness, blurred vision or shaking please test your blood sugar if you are able to do so. If it is less than 4 mmol take four glucose tablets or 150mls of sugary drink.
Your blood sugar will be checked during and after your operation and additional treatment with insulin will be given if required.
After your operation you will be offered food and drink when you feel able to eat it or when your surgery allows. If you are eating and drinking normally you should restart taking your normal diabetes medication.
You should restart your usual medication the morning after surgery however your blood glucose may be higher than usual for a day or so.
When you get home, if you feel sick or are sick and unable to eat please refer to the following sick day rules:
What should I do if I am unwell?
NEVER stop taking your insulin or tablets – illness usually increases your body’s need for insulin.
- TEST your blood glucose level every two hours, day and night.
- TEST your urine for ketones every time you go to the toilet or your blood every two hours if you have the equipment to do this.
- DRINK at least 100ml water/sugar free fluid every hour – you must drink at least 2.5 litres per day during illness (approximately five pints!).
- REST and avoid strenuous exercise as this may increase your blood glucose level during illness.
- EAT as normally as you can. If you cannot eat or if you have a smaller appetite than normal, replace solid food during illness, with one of the following: 400ml milk or 200ml carton fruit juice or 150-200ml non-diet fizzy drink or one scoop ice cream
Important
When should I call the diabetes specialist nurses or my GP?
- CONTINUOUS diarrhoea and vomiting, and, or high fever
- UNABLE to keep food down for four hours or more
- HIGH blood glucose levels symptoms of illness
(above 15mmol/L – you may need some more insulin) - KETONES at ++2 or +++3 in your urine or 1.5mmol/l blood ketones or more. (You may need more insulin). In this case, contact the person who normally looks after your diabetes immediately.
- OUTSIDE NORMAL WORKING HOURS
Consult the local out of hours service or go to your local hospital A&E department.
Other instructions to follow
- You are recommended not to drink alcohol or smoke for 24 hours before your admission.
- You are not allowed to wear jewellery other than a plain wedding ring (including all body piercing), nail varnish (including fingers and toes) makeup, hair products or hairspray.
- Following your general anaesthetic, you must not drive, drink alcohol or operate machinery for a minimum of 24 hours. This may be longer following certain types of surgery. After this time you should only resume these activities when you feel able to. If you are going home within 24 hours of your operation you must have someone to take you home and stay with you for the 24 hours.
- Please bring all your medication with you in the green bag provided by the pre-operative assessment team.
If your health has changed since your pre-operative assessment – contact us
If you are unwell prior to your operation, please contact:
- Switchboard
Telephone: 01642 850850 – Ask to be put through to your consultants secretary - If you are having Neurosurgery contact the pre-operative assessment team
Telephone: 01642 835762 or your consultant’s secretary. - If you are having Eye Surgery
Telephone: 01642 854556 - Other surgery
Telephone: 01642 854009 - Pre-operative assessment at the Friarage Hospital
Telephone: 01609 764847
Email: [email protected]
Examples are measles, mumps, chicken pox, and chest or ear infection.
If you are taking medication to help prevent blood clots
If you are taking medication to try and help prevent blood clots forming, for example, warfarin, clopidogrel, prasugrel and aspirin, this medication sometimes needs be stopped prior to your operation. If you are required to stop any medication you will have been given instructions at pre-operative assessment. If in doubt, please contact the pre-operative admission team to discuss.
Coming into hospital
Patients for admission can come alone or may be accompanied by a relative or friend. If you are accompanied, the person may stay for a short length of time in the reception area only. This is to protect the privacy and dignity of other patients. The only exemption is for carers of patients with additional needs.
What to bring with you
If you are going home the same day as your operation, we advise you bring a small bag with toiletries and reading material if required.
If you are transferring to a ward after your operation, we advise that you bring only one small suitcase or bag (maximum size 50cm x 40cm x 20cm or 20” x 16” x 8”) containing dressing gown, nightwear, slippers or indoor footwear, toiletries and reading material if required.
The trust cannot be held liable for the loss of or damage to, patients’ property (including money) unless it is handed in for safekeeping. Valuables such as money and jewellery should be left at home.
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]