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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should Insulin Be Taken Before Undergoing Cataract Surgery?

Hello doctor, My mother, aged 54, has been diagnosed with Diabetes 1-1/2 months ago. She has been suffering with Lymphoedima(swelling of the legs) since 30 years, and with Thyroid since 6 years. Now, she is due for Cataract operation. Her random diabetic count is 8 and Fasting sugar - 103, post lunch - 203 (latest). She needs to get operated for Cataract as soon as possible. Could you please advice, if she needs to take Insulin shots before the operation? Or could she continue with her medication -Gluconorm-G 2(two times a day) - till the sugars get normal and then go for operation? Kindly advice at the earliest.
posted on Thu, 13 Mar 2014
Twitter Sat, 11 Oct 2014 Answered on
Twitter Mon, 13 Oct 2014 Last reviewed on
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Internal Medicine Specialist,  's  Response
Hello,
I'm not sure what you mean by 'random diabetic count'. Is it her glycosylated hemoglobin A1c (HbA1c)? The target value for a diabetic patient is a HbA1c below 7%. Her fasting blood sugar is not high - it is within target range. If that's her usual measurements then this is OK. Her postprandial levels are higher than the target which is to keep glucose under 180mg/dL or (ideally) under 140mg/dL.
Since she is that close to the target range I doubt that a tighter blood glucose control would make a big difference to her outcome. Despite that good blood glucose control is adviced BEFORE surgery. Please consult your ophthalmologist about potentially coexistent retinal damage because a fast intervention on her mean blood glucose (HbA1c) can cause additional damage AFTER the surgery.
My opinion is that insulin is not absolutely needed, although it is the most efficient treatment for diabetes. She is very close the target, which can be reached with pills, diet and exercise.
I hope I've addressed your concerns!
If you have further questions on the subject, I'll be glad to answer.
Kind Regards!
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Should Insulin Be Taken Before Undergoing Cataract Surgery?

Hello, I m not sure what you mean by random diabetic count . Is it her glycosylated hemoglobin A1c (HbA1c)? The target value for a diabetic patient is a HbA1c below 7%. Her fasting blood sugar is not high - it is within target range. If that s her usual measurements then this is OK. Her postprandial levels are higher than the target which is to keep glucose under 180mg/dL or (ideally) under 140mg/dL. Since she is that close to the target range I doubt that a tighter blood glucose control would make a big difference to her outcome. Despite that good blood glucose control is adviced BEFORE surgery. Please consult your ophthalmologist about potentially coexistent retinal damage because a fast intervention on her mean blood glucose (HbA1c) can cause additional damage AFTER the surgery. My opinion is that insulin is not absolutely needed, although it is the most efficient treatment for diabetes. She is very close the target, which can be reached with pills, diet and exercise. I hope I ve addressed your concerns! If you have further questions on the subject, I ll be glad to answer. Kind Regards!