Work with your doctor to come up with the safest surgery plan for you.

Focus more on managing your diabetes during the weeks before surgery.

Your doctor will do a medical exam and talk to you about your health.

• Tell your doctor about all the medicines you are taking.
• If you take Metformin, talk to your doctor about stopping it. Sometimes, it can be stopped 48 hours before and 48 hours after surgery to decrease the risk of lactic acidosis.
• If you take insulin, ask your doctor what dose you should take the night before or the day of your surgery.

Surgery is riskier if you have diabetes complications. So talk to your doctor about your diabetes management and any complications you have from diabetes. Tell your doctor about any problems you have with your heart, kidneys, or eyes, or if you have loss of feeling in your feet. The doctor may run some tests to check the status of those problems.

Before surgery, talk to your doctor about maintaining a good blood sugar level during the operation. You may do better with surgery and get better faster if your blood sugar is controlled during surgery. You may be instructed to aim for a blood sugar between 80 and 150 mg/dL.

During surgery, insulin is given by the anesthesiologist. You will meet with this doctor before surgery to discuss the plan to control your blood sugar during the operation.

You or your nurses should check your blood sugar often. You may have more trouble controlling because you:

• Have trouble eating
• Are vomiting
• Are stressed after surgery
• Are less active than usual
• Have pain or discomfort

Expect that you may take more time to heal because of your diabetes. Be prepared for a hospital stay if you are having major surgery. People with diabetes often have to stay in the hospital longer than people without diabetes.

Watch for signs of infection, such as a fever, or an incision that is red, hot to touch, swollen, more painful, or oozing.

Prevent bedsores. Move around in bed and get out of bed frequently. If you have less feeling in your toes and fingers, you may not feel if you are getting a bed sore. Make sure you move around.

After you leave the hospital, it is important for you to work with your primary care team to make sure your blood sugar continues to be well controlled.

Call your doctor if:

• You have any questions about surgery or anesthesia
• You are not sure what medicines you should take or stop taking before surgery
• You think that you have an infection