Diabetes.

Waiting for surgery can make lots of things more challenging, including managing health conditions like diabetes.

For example, it can be hard to keep active and eat a healthy diet when you’re waiting for surgery. Related issues such as pain, worry, low mood and being stuck in the house more, can contribute to boredom or comfort eating, which can lead to weight gain.

All of these things can result in higher blood sugar levels.

Unfortunately, uncontrolled diabetes is a common reason that surgeries are delayed or even cancelled.

Diabetes and your surgery

Having high blood glucose levels can increase the risk of complications during and after surgery, and lead to slower recovery time after an operation.

For this reason, people who have diabetes might have their operation cancelled or delayed* until their glucose levels are within a safer range, which can add weeks or months to the time spent on the waiting list.

Although this can be frustrating, patient safety is always the priority when making these decisions.

* Fitness for surgery is assessed at the Pre-Assessment Clinic appointment.

People with uncontrolled diabetes tend to have longer hospital stays and poorer outcomes after surgery.

High blood sugar levels contribute to problems like infections, poor wound healing and taking longer to recover.

If you have diabetes, having well-controlled blood sugar levels reduces these risks, and reduces the chances of your surgery being delayed or even cancelled.

The good news is that there’s lots of evidence to show that taking steps to reduce high blood sugar levels improves surgery outcomes and also long-term health.

Know your numbers!
  • Your HbA1c test result needs to be below 69 for surgery to go ahead. Some types of surgery might require a lower result.
  • The HbA1c test is a blood test which is done each time you have diabetes review.
  • It gives an indication of what your blood sugar levels have been like over the last 3 months.
  • It should be checked at least once a year.

Ask your diabetes care team if you’re not sure what your most recent HbA1c result was.

Home blood glucose monitoring (fingerprick tests)
  • If you use a blood glucose meter to test your blood sugar levels at home, the readings should be in the range of 4 to 10mmol/l most of the time, to be safe for surgery to go ahead.
  • Don’t just test your blood sugar first thing in the morning. Blood sugar levels are often at their lowest when people first wake up – but not always! It’s important to test at different times of the day to get an overall picture of your blood sugar levels.

Ask your diabetes care team for advice about how often and when to test your blood sugar levels.

Glucose sensors

If you use glucose sensors, check the reports to find your:

  • Estimated HbA1c – this needs to be below 69mmol/mol (8.5%)
  • Average glucose – aim for less than 10mmol/l, but without causing more hypos (too low blood sugars)
  • Time in target range – if this is below 40% aim to increase your time in target towards 70%

Ask your diabetes care team for support if you’re unsure where to find the reports mentioned above.

At your diabetes review appointment:
  • Let your diabetes care team know that you are on the waiting list for surgery so that they can help you to make sure your blood sugar is well controlled.
  • Ask yourself some honest questions before you go to your appointment. For example “Am I eating as well or being as active as I could be?”. If the answer is no, ask for some advice about setting helpful, realistic goals to make positive changes.
  • It can also help to check that you are taking any prescribed diabetes medications at the right time.
  • Ask about Diabetes education programmes in your area, to help you learn more about diabetes and how to manage it.
At your surgery or surgical Pre-Assessment appointments:
  • Make sure you discuss your diabetes and expected targets for surgery.
  • The surgery team can sometimes refer you to local services to help you manage your diabetes for surgery.
  • They can write to your GP practice and ask them to help you improve your blood sugar levels for surgery.
  • At your anesthetics appointment before surgery you will be given advice about how to manage diabetes medications when you come in for your procedure.
Diabetes UK website and care line

There is lots of information about diabetes online. It can be hard to know if the information can be trusted or if it’s safe to follow.

Diabetes UK is the leading national diabetes charity. There is lots of reliable information about living with and managing diabetes on the Diabetes UK website.

Call Diabetes UK on 0345 123 2399 to talk to someone about living with diabetes and get support.

Healthy Living for people with Type 2 diabetes

NHS England online information and diabetes education for people living with type 2 diabetes in England.

Find out about how to sign up for Healthy Living here