Rapid acting insulin pre meal + background insulin once or twice daily

Follow the usual instructions in the information you will have been given, click here.

On the day before coming into hospital take your insulin as usual. Have a snack before going to bed such as a piece of toast.

7.30am or 8am admission – for surgery on the same morning

  • Do not eat on the day of your operation (nothing after midnight). You may have a drink of water at 6am and then nothing to drink after this time.
  • Do not give your morning dose of rapid acting insulin. If you normally take a long acting background dose in the morning this should be reduced by 20 per cent.

Please be aware if your blood sugar  is above 15mmols on admission, your surgery may need to be postponed or cancelled.

Late morning or 1pm admission – for surgery that afternoon

  • Give your usual dose of rapid acting insulin with food as below. If you normally take a long acting background dose in the morning this should be reduced by 20 per cent.
  • You may have a light meal such as tea/coffee and toast before 7am.
  • Have a drink of water before 11am on the morning of your procedure.
  • Do not drink anything thereafter.
  • Do not give a lunchtime dose of insulin.
  • Monitor your blood sugars during the morning  –  see  advice  re Hypoglycaemia treatment.

Once home following surgery you should restart your usual insulin when the next dose is due.

What should I do if I am unwell following surgery?

When  you  get  home,  if  you feel nauseated or vomit, and are unable to eat as normal, replace food with one of the following:

400 mls of milk or
200 ml carton fruit juice or
150-200 mls non-diet fizzy drink or
1 scoop of ice cream

  • Ensure you continue to take your usual insulin – illness usually increases your body’s need for insulin
  • Drink at least 100 mls water/sugar-free fluid every hour, you must drink at least 2.5 litres (five pints) per day
  • Rest and avoid strenuous exercise
  • If you carry out your own blood tests, these should be done every two hours day and night whilst feeling unwell
  • Test your urine or blood for ketones every two hours, if you have the equipment to do this

If you do not improve quickly and usually attend the hospital for diabetes care then telephone Diabetes Team  – number on back of this leaflet. Outside these hours   contact your GP practice or out of hours service. If you usually see your GP about your diabetes then phone your GP practice.

Remember to bring into hospital

  • Glucose tablets
  • Blood testing equipment you usually use
  • Insulin you usually take for your diabetes

Treatment for Hypoglycaemia

(if blood sugar less than 6 mmol/litre)

  • If you have any symptoms of low blood sugar such as sweating, dizziness, blurred vision or shaking please test your blood sugar
  • If it is less than 6 mmol/l take 150 mls of a non-fizzy sugary drink or four glucose tablets
  • After ten minutes repeat the blood test. If the result is still 6 mmol/l or below please repeat the above advice.
  • On arrival at the hospital please tell the staff that you have done this as it may be necessary to delay your surgery.

These instructions are only a guide. If you feel that you need additional advice, please contact:

Diabetes Specialist Nurses
(Monday – Friday mornings)
01935 384 517

Ref: 19/18/104A
Review: 08/20