My life has been profoundly impacted by managing Type 1 Diabetes since the age of two, alongside my battle with breast cancer ten years ago. As a mother who underwent three C-sections, I learned the importance of careful diabetes management. During my pregnancies, I was fortunate to have a knowledgeable endocrinologist who guided me through the complexities of managing my blood sugar levels. However, when I was diagnosed with breast cancer, that endocrinologist had retired, leaving me to navigate this new challenge without their expertise.

During my breast cancer surgery, my glucose levels were not adequately monitored, resulting in a dangerous spike over 400. This mismanagement led to a serious infection and the removal of my implant. Following the initial surgery, I faced three additional procedures, the last being in 2024 for a hernia caused by the reconstructive surgery.

After surgery, I was on morphine, which left me groggy and unable to manage my own care. At that critical moment, my daughter took over the responsibility of managing my insulin through my pump. Unfortunately, the operating room staff were unfamiliar with how to use my insulin pump, adding another layer of concern during an already stressful time. Thankfully, during my last surgery, I had an endocrinologist present who was able to provide insulin when glucagon was administered for nausea. This proactive management greatly improved my blood sugar control and overall recovery.

It is crucial to emphasize that anyone using insulin, whether they are Type 1 or Type 2 diabetics, needs to be closely monitored, especially during medical procedures. Additionally, anyone undergoing surgery would benefit from wearing a continuous glucose monitor (CGM). High blood sugar can happen to anyone, particularly when glucose is administered during surgery to prevent nausea. High blood sugars can lead to serious complications, such as infections, which place a costly burden on the healthcare system. Many individuals aging with diabetes face significant challenges and often lack necessary support when they need it most. This gap in care can lead to serious complications, as I experienced firsthand.

Moreover, the lack of proper monitoring during surgery not only impacts patient health, but also leads to increased costs for insurance providers. When blood sugar levels are not managed effectively, the subsequent complications can result in extended hospital stays, additional surgeries, and increased medical interventions—all of which burden the healthcare system financially. Addressing these gaps in care could ultimately save insurance companies significant amounts by preventing complications that require costly treatments.

My journey has underscored the urgent need for comprehensive diabetes management in surgical settings, particularly for patients with complex health needs. It highlights the critical importance of ensuring that healthcare providers are adequately trained to monitor blood sugar levels, especially when administering interventions like glucose to prevent nausea. This experience reinforces the call for more endocrinologists, nurses, and diabetes educators to be available in surgical environments, where their expertise can significantly improve patient outcomes. As we advocate for better integration of diabetes care into surgical procedures, we can help prevent complications that not only affect individual patients but also place a tremendous financial strain on the healthcare system.

Ensuring that diabetes management is prioritized during surgery requires proactive communication and preparation. Here are several strategies that patients can adopt:

• Preoperative Consultation: Schedule a meeting with your endocrinologist or diabetes care team well before the surgery. Discuss your medical history, medication regimen, and any specific concerns related to managing your blood sugar during the procedure.
• Informing the Surgical Team: On the day of the surgery, make sure to inform the surgical team about your diabetes. Bring a copy of your diabetes management plan, including your insulin regimen and any specific instructions from your endocrinologist.
• Continuous Glucose Monitoring (CGM): If you use a CGM, ensure that the surgical team is aware of it and understands how to interpret the readings. If possible, advocate for the use of the CGM during the surgery to monitor your blood sugar levels continuously.
• Designating a Caregiver: Assign a family member or friend to be your advocate during the procedure. This person can communicate your diabetes needs to the medical staff, especially if you’re unable to do so due to anesthesia or medication effects.
• Postoperative Follow-Up: After the surgery, continue to communicate with your healthcare team about your recovery and any fluctuations in blood sugar levels. This will help you receive the necessary support and interventions if complications arise.

By taking these steps, patients can help ensure that their diabetes management is prioritized, reducing the risk of infection, and improving overall outcomes.