What to Expect

Diabetic Patients

These are general instructions only. If you have any questions or concerns, please contact Specialist Anaesthetic Services on 8273 5666 prior to the day of your procedure.

Fasting:

All food should be stopped 6 hours prior to your surgery time. You may drink water up to 2 hours prior to your surgery time.


DIABETIC patients on TABLETS – please follow these instructions:

Morning Operation

You will be placed as early as possible on the operating list and you will need to follow these instructions:

  • At 6am have a glass of water

  • Do not take your Diabetic tablets on the morning of your operation, but bring them with you to the hospital

Afternoon Operation

  • Eat breakfast as normal

  • Take your morning Diabetic tablet as normal

  • Clear fluids (water) until 11am, then fast


DIABETIC patients on SGLT2 inhibitor tablets* (“gliflozins”) – please also follow these instructions:

Special instructions are necessary for this newer class of oral diabetic medication due to the small risk of diabetic ketoacidosis.

*Drugs concerned: dapagliflozin, Forxiga, empagliflozin, Jardiance, ertugliflozin, Steglatro, Xigduo, Jardiamet, Segluromet, Glyxambi, Qtern, Steglujan, Qternmet

Recommendations when fasting for surgery

  • For minor operations, such as cataract surgery, with no risk of dehydration, no bowel prep and with rapid resumption of normal food and fluid intake following the procedure: Stop diabetic medication on the day of surgery only. Restart only when on full oral intake.

  • For all other Operations: Cease SGLT2i (“gliflozin”) at least 3 days pre-operatively (2 days prior to surgery and the day of surgery). This may require an increase in other glucose-lowering drugs during that time. It should be noted that if the SGLT2i is part of a fixed dose combination this will lead to withdrawal of two or even three glucose-lowering drugs. SGLT2i should only be restarted post-operatively when the patient is eating and drinking normally, or close to discharge from hospital.

The patient must check blood glucose and blood ketone levels if the patient has been taking these medications and is unwell in the week following surgery.

Based on Australian Diabetes Society August 2019 Alert



DIABETIC patients on INSULIN – please follow these instructions

Morning operation

You will be first on the list and will need to follow these instructions:

  • Take half of the Insulin dose the night before, plus a night-time snack before midnight

  • At 6am on the day of the operation, have a glass of water

  • Take NO Insulin on the day of the operation but bring your Insulin with you to the hospital

Afternoon operation

If your operation is in the afternoon please follow these instructions:

  • Have your breakfast & morning tea as normal

  • Take half of the Insulin dose due in the morning of your operation & bring your Insulin with you to the hospital