James <
[email protected]> wrote on Fri, 6 Feb 2004 02:47:04 -0700:
> I am a 30 year old Type 1 and I currently take Lantus and Novolog. I am having oral surgery
> (wisdom teeth out) next month.
Ah! You mean, you're going to the dentist! Got you!
As a matter of interest, how long have you been T1?
I'm a 46 y.o. T1, and spent time (a lot of it) at the dentist last year getting lots of crowns
fitted. It was all done with local anaesthetics, though. No particular problems, there.
> I have never been put under anesthesia, and am more than a little concerned about how my body will
> react and what will happen to my blood sugar while I am asleep.
I've had a general anaesthetic just once, when my knee was getting seen to after a skiing accident.
But the surgeon and his team knew all about my diabetes. I'd had no insulin and no food on the
morning of the op.
:-( Somehow, when I woke up a fraction of a second later (subjective
time), my BS was merely very high, not at danger levels.
> Since I am guaranteed to not wake up if I get low, ....
How so? I went low to the point of unconciousness quite a few times in the distant past. I always
woke up again. At a certain point, the liver kicks in with a glucose dump. Leaves you feeling
rotten, but alive.
> .... I am thinking about taking a low basal dose or none at all on the day of the surgery.
I wouldn't omit your basal dose. Do you really want to end up in the emergency ward with DKA? But
reducing it might be an idea. Or alternatively, increase it, more or less eliminating the Novolog.
Trouble is, Lantus is quirky stuff, building up its action over days rather than responding
immediately to changes.
> Thoughts/advice on dealing with surgery from those taking insulin?
Don't panic! Eat well the day before, so you won't go hungry! And don't even bother trying to keep
within 80-120. 120-250 is a more sensible target.
How long are you going to be unconscious for?
What does your dentist say? Is he helpful or dismissive? What does your DM specialist say?
And take some aspirins with you, to control the pain in your mouth afterwards (but make sure they're
OK to use).
--
Alan Mackenzie (Munich, Germany) Email:
[email protected]; to decode, wherever there is a repeated
letter (like "aa"), remove half of them (leaving, say, "a").