Newly diagnosed daughter having surgery

My 17 year old daughter was diagnosed this year with T1D in February. Next week she will be having an out patient surgery for the first time since being diagnosed. Her doctor only said to lower her night time dose. Does anyone have any suggestions they might have learned by having surgery?
Thank you

It seems somewhat odd that the doctor would want the basal dose lowered, but that may have to do with what surgery is being performed. Two things while staying in a hospital. First if at any time an IV is attached with a saline drop or other to maintain fluids ensure that it is a zero sugar drop it is common that some IV has sucrose or fructose which can raise BG if you demand a zero sugar IV it must be provided by law. Secondly often the meals provided in the hospital can be high carb which will raise BG. At this point in time, being newly diagnosed it is imperative for your daughter to maintain strict control of her BG doing so will allow some beta cells in her pancreas to keep working. Often when in the hospital doctors will keep a Diabetics BG elevated for fear of a hypoglycemic episode. Proper control will fend against both high and low blood sugar. For the best information on BG control I recommend Dr. Bernsteins book (Dr. Bernstein's Diabetes Solution - Dr. Bernstein's Diabetes Solution. A Complete Guide to Achieving Normal Blood Sugars. Official Web Site) He is an endocrinologist who has had T1 diabetes for 69 years.

Thank you for your advice!! I will look into Dr. Bernsteins’ book. Also, I would never would have thought about a zero sugar IV. She has had surgeries before and I never worried about the “little” stuff before. It seems now that I will need to understand everything that goes into her not just food. Thank you for waking me up!!

Personal experience leads me to go with the suggestion that the background insulin be reduced the evening before surgery and that she monitor BG levels often. I’ve had a number of out-patient procedures involving anesthesia since I’ve been pumping and about 9 PM the evening before surgery I start a temporary basal rate of 60% to run for the next 12 to 16 hours. This has worked well except for one occasion when I had to do a correction bolus. It is true that the stress may elevate her blood sugar but this can be managed with an appropriate bolus.

A suggestion if your daughter does not do this is on a few nights prior to scheduled surgery that she plan to get up during the night a couple of tines and test - this may help decide how much her insulin could be safely reduced.

Before demanding a zero glucose IV drip, discuss this with her endocrinologist and any other attending physician - very often, glucose, attended by proper insulin, may be required for the patient’s well being.

Hi! Just found out my 8 year old with t1d will have to have oral surgery. 1st surgery since dx or year ago. My Endo said they would like to know 2 weeks before surgery and that they will have a conversation with the md/surgeon beforehand. Lowering lantus at night will be necessary as he wont be able to eat anything in the morning due to anesthesia. I’m definetly nervous about it and feel sad the poor guy has to go through this too!!