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Minor Procedures | Surgery | Pregnancy | Travel

 

There are many things which happen in our lives which are routine for most people.

However, having diabetes can make them more complicated.

Listed below are a few of the more common examples…

 

 

This would include, for example, tests which require you to fast for a period, such as bowel examinations, or dental procedures where you can’t eat for a period of time…

Dealing with these will depend upon your treatment and the nature of the event. However, in general:

  • If you are on tablet treatment and the event is short lived, you will generally be quite safe to delay taking your tablets for a few hours and restart when you are able
  • If you are asked to fast for a period, and you are on tablet treatment, it is often OK to stop the tablets altogether for the duration of the fasting.
  • If you have type 1 diabetes, you must never stop your insulin. Short term fasting is dealt with by reducing the dose of insulin until the procedure is complete, or taking small amounts of sugar to cover the insulin doses.
  • For many procedures, there will be an information sheet for people with diabetes. Ask to see if there is one available.

This would include, for example, tests which require you to fast for a period, such as bowel examinations, or dental procedures where you can’t eat for a period of time…

Dealing with these will depend upon your treatment and the nature of the event. However, in general:

  • If you are on tablet treatment and the event is short lived, you will generally be quite safe to delay taking your tablets for a few hours and restart when you are able
  • If you are asked to fast for a period, and you are on tablet treatment, it is often OK to stop the tablets altogether for the duration of the fasting.
  • If you have type 1 diabetes, you must never stop your insulin. Short term fasting is dealt with by reducing the dose of insulin until the procedure is complete, or taking small amounts of sugar to cover the insulin doses.
  • For many procedures, there will be an information sheet for people with diabetes. Ask to see if there is one available.

Having diabetes does not stop you having a normal pregnancy and delivery, but it will involve a lot of input into your diabetes management during the pregnancy and a few extra scans. We will not go into the detail of management of diabetes and pregnancy here, but remember the following points.

  • If you have diabetes and you are considering starting a pregnancy, discuss this with your GP or diabetes team early
  • Do not fall pregnant or attempt pregnancy until you have discussed your diabetes control and treatment
  • Certain commonly taken medicines are harmful in pregnancy and need to be stopped before pregnancy
  • Poorly controlled blood sugar in early pregnancy can harm the baby. Make sure you have discussed the control of your diabetes before considering pregnancy
  • Once you are given the go ahead, you need to take a vitamin called folic acid to avoid spinal problems for the baby.
  • People with diabetes have a lot more appointments in the antenatal clinic during pregnancy than people without diabetes, so be prepared for a busy time.

Any holiday or travel, but particularly travel abroad, disrupts routines. There are a number of basic points to remember.

  • Your food intake is likely to be different, both in terms of timing and content. Keep an eye on your blood glucose as it can vary quite considerably from your usual home figures.
  • If in a hot climate, people on insulin can find that the insulin is absorbed a lot quicker, so keep this in in mind and be careful. Ensure you store your insulin in a cool place.
  • Alternatively in a cold climate the body may require more fuel to keep warm. This may lead to lower blood glucose levels if insulin is not adjusted. Ensure your insulin is stored appropriately. It must never be frozen.
  • It is worth remembering that extremes of either heat or cold can affect insulin, test strips and how your blood glucose meter operates so be mindful of this and check the manufactures instructions.
  • Tummy upsets are common while travelling. If you are being sick or have diarrhoea, you may need to miss your tablets. People on insulin need to keep taking it, but you may need to take a smaller dose and will need to keep some carbohydrate intake, even if in the form of sugar solution or jam (See section on ‘sick day rules’)
  • Take extra supplies of your insulin, tablets and blood glucose testing strips.

Air travel across time zones is an issue for those on insulin. You may need to get advice on this from your diabetes team, but the basic rules are as follows:

  • Take you insulin as usual on the day of travel
  • Plan to take your insulin as usual by local time on arrival at destination
  • Work out the time gap between insulin injections using this scheme.
  • If the gap is longer than usual, you may need an additional small dose in between. If it is shorter, you may need to reduce the dose on arrival.
  • Do not keep insulin in the hold of the aircraft as it may be damaged by temperature change. Carry a letter from your health care professional to say that you have insulin and needles in your hand luggage to avoid any problems at customs.

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pals@solent.nhs.uk

 0800 013 2319

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The Act sets out exemptions to that right and places certain obligations on public authorities.

Email: InformationGovernanceTeam@solent.nhs.uk

Phone: 0300 123 3919

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