Diabetes mellitus and surgery
At a time when insulin was not yet accepted as a radical treatment for diabetes, most surgeons were reluctant to operate on diabetics.
Patients with disorders of all metabolic processes endure the operation and the postoperative period with more pronounced painful phenomena.
With small interventions without long-term food restriction, people with diabetes may remain on diet or oral hypoglycemic drugs. For large operations with a long break in food intake, insulin must be prescribed.
Optimally, the operation in diabetic patients is carried out at the beginning of the week – this guarantees constant medical monitoring of how much diabetes is compensated. Such small interventions as gastroscopy, bronchoscopy, tooth extraction, abscess opening should be carried out, if possible, when compensating for diabetes mellitus.
Pain and disruption of the usual daily routine can quickly lead, especially in patients with labile juvenile diabetes, to decompensation.
In case of violations of insulin or dietary regimens during the preparation of patients for surgery or in the postoperative period, undesirable consequences may occur.
The main problems of surgical interventions for diabetes are the risk of bleeding and poor, long-term healing of tissues, the risk of divergence of surgical sutures, suppuration, and others . However, when it comes to saving life, of course, such patients are operated on without waiting for compensation for diabetes mellitus.
During the operation and after it, the administration of insulin, the infusion of glucose solutions, amino acids, and treatment with all types of antibiotics are widely used. The use of insulin in the preoperative and postoperative periods is always mandatory. This applies equally to patients with mild diabetes mellitus, who are usually not treated with insulin.