Anesthesiologist Questions Diabetes

Can anesthesia be administered to a patient with diabetes?

My husband is diabetic with an HBA1C of 9. He has to undergo a surgery to remove the pus accumulation around his ankle. The surgery should ideally be done under anesthesia, but given his diabetic condition is the anesthesia safe for him?

16 Answers

Generally speaking yes. He is at increased risk of cardiovascular complications
Diabetes has little or no effect on anesthesia. Doctors and nurses monitor the blood glucose of diabetic patients throughout the perioperative period.
It would be best to optimize his diabetes and then he could safely undergo anesthesia...the assumption is for elective surgery.
There are many different anesthetic techniques which can be used in a situation like this. The diabetes itself is not huge problem, but all of the accompanying medical problems must be considered. In some cases, surgeons may want to postpone surgery until tighter control of blood glucose can be obtained. A case like this is more of an emergency. Diabetic patients are more prone to infection and less able to heal than other patients. Anesthesia is very safe for almost all patients, and monitoring systems have made it unusual to have complications related strictly to the anesthesia. Most complications are related to medical or surgical issues and are not related to the anesthetic choice or technique
Well, if pt has pus, that needs draining. Can be done under ankle block with sedation if needed!
Yes, anesthesia can be administered to a diabetic patient. If he has pus in his ankle then he needs to have the infection treated otherwise his diabetes will be more difficult to manage and his infection will worsen due to the uncontrolled diabetes. Keep in mind, that your husband does not have to undergo a general anesthetic, which is what I believe your question is based. There are nerve blocks that can be done to provide anesthesia for the surgery and he does not necessarily need to have general anesthetic. As to safety of anesthesia, I have anesthetized hundreds, if not thousands of patients with diabetes without a bad anesthetic outcome, so yes it should be safe. The information I share here is based on the limited information you have shared with me.
Unfortunately you have given me little to work on. How old is your husband and particularly how long has he been diabetic and are we dealing with a superficial infection or something more complex such as osteomyelitis. Blood supply is critical to healing and diabetes can virtually destroy critical microcirculation to the feet and portends a poor prognosis in salvage of the foot and eventually the lower leg. I have no idea as to your husband’s cardiac, pulmonary or renal status. Does he have a peripheral neuropathy? Many advanced diabetics have such numbness in their feet that are virtually anesthetic. An important consideration as well is your husbands BMI.

The two most important factors are to get your husband in optimal medical condition as time permits and select a board certified anesthesiologist competent in regional anesthesia.

This is not medical advice as I have inadequate information regarding your husband. A board certified anesthesiologist can usually manage such a problem as it is not uncommon.

Additionally, I would explore the use of hyperbaric oxygen therapy both pre and post operatively to enhance healing.

May God bless.

Best regards,

William E. Webb, Jr., M.D.
Patients often have diabetes, or high blood pressure, or heart disease, or a combination or myriad of other diseases when they present for surgery. Anesthesiologists take a thorough history and physical and tailor the anesthetic to the patient based on the type of surgery and the patient's medical history. Hundreds of thousands of diabetic patients successfully undergo surgical procedures everyday. Communicate with your surgeon and anesthesiologist and you can be confident in receiving the best care to meet your needs.
He has infected foot. Yes, anesthesia can be given safely. Needs to have proper control of blood sugar. Should be taken care post op. His blood sugar can be controlled perioperatively.
Yes. If elective, blood sugar should be controlled. If emergency surgery, we do our best to control blood sugar.
Yes. Anesthesia can safely be administered to this patient, preferably with the monitored anesthesia care method combined with local anesthetic supplemented by the surgeon. This ankle infection needs to be treated and evacuated ASAP.
Thank you. Best, 
Benjamin Taimoorazy, MD FAHSDABPM DAAPM UCNS
The anesthesia can be safe for him if it's done under local anesthesia. His physician should be working to reduce his blood glucose and then HBA1C.
Yes ... He could have Subarachnoid block " Spinal Anasthesia "
I am sorry to answer your question so late. I do not know when you posted this question, but it just came up on my feed.

The anesthesia can be provided safely for your spouse. Depending on other medical conditions and extent of the infection, the anesthesiologist may choose to either do a general anesthetic or with local/regional anesthetic.

Dr Ketch
Yes, most procedures such as this can be done under local, regional or general anesthesia. The anesthesiologist will consult with the surgeon and physician providing diabetic care to develop a plan that is the safest for your husband.
It is safe. The anesthetic isn't going to affect it. However, healing might be an issue. You have to make sure the wound is properly cared for.