T2 Diabetic and morning procedure! This is urgent! pls look

[Chongo989]

So.. In the morning at 9am, I go to the oral surgeon to have all my darned teeth removed and fitted with dentures. I will be IV sedated with the Versed/Fentanyl cocktail, and was told not to eat anything after midnight. Now one thought that completely skipped my mind to ask the dentist is... I am a T2 diabetic, and I've got good blood glucose control. Should I take my diabetes meds? If I'm not to take anything before the procedure, and no idea how long it'll take, as well as recovery and be cognitive enough to eat or drink something without choking, I may run the risk of a hypoglycemic episode. So.. Should I take my meds (Actos/Metformin/Lantus) and attempt to try to eat a milkshake or something, or not and deal with elevated BG levels for the sake of not bottoming out? I can deal with high blood sugar, but running low is dangerous.
Thanks in advance for any insight.

 

[FearfulInMA]

You should call your primary care/GPS office as soon as they open in the morning. They may also have an on-call that you can talk with tonight. They can tell you how to best manage.

 

[Tink]

Hi Chongo -

I have diabetes too, I recognise that dilemma! I take gliclazide so do get hypos if I am not able to eat at regular intervals.

My best advice would be to contact your diabetes care team for advice, although I appreciate it may be too late for that. Certainly call them if you at all can.


Either way, you will likely be OK.

Make sure the oral surgeon knows about your diabetes and the risk of a hypo - they can test your BG during treatment and keep hypo treatments on standby. I'm sure you already know this, but there are ways of treating a hypo if you are too out of it/sedated to swallow - there are fast-acting glucose gels that can be rubbed into the inside of your cheek, or for more serious hypos there is even injectable stuff. So it's fixable, as long as the people treating you are aware and on it. They should be well used to treating people with diabetes.

For what it's worth, in the short term for something like this I tend to opt to run high, because as you say, low can present the more immediate short-term risk. Best done after consulting with your diabetes doctor if you can though.



Note that anxiety can affect your blood glucose too, sometimes in unpredictable ways. Whatever you opt to do, make sure that you keep testing when you're awake, and ask the oral surgeon to monitor your BG while you are sedated, for peace of mind.

 

[LittleLynnie]

My pre-op instructions from my oral surgeon (had all my uppers removed a week and a half ago), were to not have anything to eat or drink for 8 hours before the procedure, but to take any necessary medications with as little water as possible (but to definitely take them if it was important to do so). I don't know what time zone you're in, or if you'll get this reply in time or not, but do try to contact either the dental office or your GP, as early in the business a.m. as possible. And good luck with the procedure!

 

[Chongo989]

Ya, I wish I would have thought about this when it was withing business hours.. Well, in the end I just took my pills, and didn't take the insulin. I did take a cup of coffee with 2 real sugars to bump my bgs. The dentist commended me for the decision, monitored my BG during the procedure and all went as planned. Thank you all for the advice anyhow.

 

[Tink]

Hey Chongo, glad to hear it all worked out well for you! Taking just the pills sounds like a sensible compromise, I did wonder if just taking some of your medications would be an option.

Well done for figuring it out, we do sometimes have to be pretty self-sufficient with managing diabetes, don't we?

Hope you make a speedy recovery.