Concerned about how a hospital stay could affect your diabetes? With careful preparation and advice from your healthcare team, you shouldn’t encounter any problems going to hospital for surgery or other procedure.

What steps should you take?

1. Talk to your primary care doctor and medical staff about your diabetes in any pre-operative appointments. Come prepared with questions so you can undergo your surgery with confidence.
2. Consider your diabetes routine when booking your surgery. Wherever possible, you should be booked first on the surgery list. Remember to eat at the right times.
3. Need to fast? Monitor your blood glucose levels (BGLs) closely before your surgery. Get advice from your healthcare team if you need to make changes to your diabetes medication.
4. Bring all your medications, along with information on dosage amounts and times. Keeping your BGLs within target range will help in your recovery.
5. Note down any required changes to your diabetes management after surgery.
6. A pre-operative assessment allows your surgeon or other medical staff to gather relevant information about you.

Questions to ask

Talking to your medical team will give you the confidence that your diabetes will be well-managed before, during and after your procedure. Here are some questions you might like to ask your medical team:

1. Do I need to stop any medications prior to surgery? Meet with your endocrinologist or diabetes treating team to discuss whether your diabetes medications need to be stopped or changed before hospital admission. 
2. Do I need to adjust my insulin doses (particularly if fasting)? The type of insulin you take and the nature of your procedure will need to be considered. Discuss whether you may need to take a reduced dose or no insulin with your medical team if you’re required to fast.
3. Should I bring my diabetes medications to the hospital? It’s important to let the medical team know all your diabetes medications, including vitamins, herbal medications and over-the-counter medications, during the pre-admission process. They will advise you on which medications to bring with you to hospital.
4. Will I be able to do my own insulin injections? Some hospitals have strict policies regarding self-administered insulin injections. A diabetes educator may assess your insulin injection regime before allowing you to administer it on your own.
5. Will I be able to stay on my insulin pump? Procedures regarding pumps vary between hospitals. Using an insulin pump during surgery should be discussed with the anaesthetist and proceduralist. You may need to detach your insulin pump and take your insulin via an intravenous drip. If you can continue to use your pump during your hospital stay, it’s a good idea to change your insulin pump line before admission. Remember to take all your pump supplies, batteries, and a list of your pump settings with you. 
6. Should I check my BGLs more often before my hospital stay? You may be required to monitor your BGLs more frequently leading up to your hospital stay. Having your diabetes under control prior to admission can reduce the risk of infections and slow wound healing. 
7. How should I manage hypoglycaemia (low blood glucose) if I’m fasting? Should I call the admissions team If I have a hypo during my fasting period? A hypo (BGLs less than 4mmol/L) may occur when you’re fasting. Here’s what to do: Check with your healthcare team if there’s a preferred treatment method, such as a glucose gel.   Let the team know if you’ve taken any hypo treatment, as this may delay or cancel your surgery. If in hospital during a hypo, tell the staff. They may give you glucose via a drip line directly into your bloodstream. 
   

Learn more about surgery and hospital stays by downloading the NDSS surgery and hospital stays fact sheet.  

Private health insurance

There are a number of things people with diabetes should consider when choosing private health insurance. This includes what additional services and treatments are covered. When undergoing surgery, your insurance cover can help you confidently access adequate healthcare for your condition. Getting the right policy is important. Talk to a few insurance providers to find the best one for you. Here are a few things to consider:

• Are there additional services and treatments covered? For instance, visits to credentialled diabetes educators, podiatrists, dietitians and exercise physiologists.
• Are glucose monitors covered? These are included as an ‘extra’ in some policies.
• Are insulin pumps included? Under current law, insulin pumps are included in the Gold Tier of private health insurance policies.

Can a provider refuse to insure you because of your diabetes?

By law, health insurance companies cannot refuse to insure you because you have diabetes or other chronic condition. They also cannot charge you higher premiums than someone without diabetes. However, they are able to enforce waiting periods for existing conditions (within the prescribed limits). Contact us for advocacy advice about private health insurance in your state.