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From Illinois, USA:

I am a young adult (20 years old) with Type 1 diabetes. I was diagnosed six years ago. I am having my wisdom teeth removed and I will be put to sleep and I cannot eat after midnight the night before. Should I take my regular insulin dosage that night and morning?


There are a million different schemes to cope with this sort of situation.

My advice to my patients:

  1. Double check with the doc (or dentist, in this case) whether it's possible to change the cut-off time for when you're not allowed to eat (called in medical lingo "NPO"). Usually, 6 hours without food is plenty, and if you point out that you don't want to get dehydrated, they'll probably agree with changing the "NPO" time to much closer to the actual time of your procedure.
  2. What to do with your insulin depends on what program you're on: if Regular is the only insulin that you take in the morning, withholding it is inviting trouble! (On the other hand, if you're on NPH or other "cloudy" insulin also, the doses might be cut back or continued unchanged). You'll have to ask your diabetes doc what he/she would advise.
  3. Don't listen to insulin advice from anyone but your usual diabetes team. If the surgeon or dentist (or their nurse who talks to their pre-op patients) says something that doesn't make sense to you, tell your diabetes doctor, and ask him/her to intercede on your behalf, by contacting the surgeon and explaining what should be done!
  4. Plan to bring your blood sugar meter with you on the day of the surgery. If there are long delays, you could check your own sugar level now and then, and be sure everything's going reasonably well.
  5. If you're going to be knocked out with a general anesthetic, be sure someone knows how to check your sugar while you're unconscious, and that they plan to do it occasionally (perhaps every hour while you're out or groggy afterwards).
  6. If you're going to be knocked out with a general anesthetic, be sure you have an "i.v." (intravenous line) to give you fluids and minerals and dextrose as needed.


Original posting 9 Nov 96


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Last Updated: Tuesday April 06, 2010 15:08:52
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