Hi, this is Dr. Hourglass, and welcome to
another video in our channel Superhourglass.
Today we are going to discuss the implications
of diabetes for cosmetic surgery.
In this channel, we will discuss everything you need
to know for you
to get the hourglass shape you’ve always wanted.
Welcome back!
Diabetes is a common condition among the United
States population.
There are actually two types of diabetes:
type 1, where patients require insulin, and
type 2, which can be controlled with diet as well as oral medication.
The metabolic impact of surgery, fasting, and interruption of glucose therapy
contributes to poor glucose control, which in turn can significantly increase mortality, morbidity,
and length of stay in patients with diabetes.
Patients with diabetes have a higher incidence
of complications after surgery,
so the reason for maintenance of blood sugar during the
surgery is to decrease
the adverse outcomes related to this condition.
High blood sugar or hyperglycemia is associated with an increase of adverse outcomes
in hospitalized patients with both medical and surgical conditions,
whether the patient is known to have diabetes
or not.
There is a strong correlation, and studies have shown that having high blood sugar
during the surgical procedure increases complications following surgery, including infection.
Blood sugar control during the first day after surgery helps prevent infection.
In addition, diabetic patients are more prone to what is called nosocomial infections,
which are infections that are actually acquired while you are at the hospital.
Treatment of postoperative high blood sugar reduces the risk of adverse outcomes.
Prevention of high blood sugar also reduces the risks
of postoperative complications from any surgery.
While modern anesthetic and surgical techniques
have reduced the metabolic impact of surgery,
because surgery creates stress during the
procedure, including increasing the hormones
of the body as well as the overall metabolic
impact on the body, studies have shown and
we can infer that any patient with diabetes
needs to have their blood sugar well controlled;
this includes cosmetic surgery patients.
The distinction between type 1 and type 2 diabetes can be very difficult,
especially if somebody has been a type 2 diabetic for a long time.
Type 1 diabetics are prone to develop what
we call diabetic ketosis or ketoacidosis
within hours if insulin is withdrawn or omitted,
especially at times of physiological stress
such as surgery when counter-regulatory hormone
production is increased.
Type 2 diabetics may also develop diabetic ketoacidosis with sufficient physiological stress
and sufficient insulin deficiency; such patients usually
have been diabetic for more than ten years.
In other words, the more insulin deficient the patient is, the greater the metabolic impact of surgery.
This is the reason that postoperative high blood sugar should be anticipated
and prevented in such patients when they undergo
a major surgery.
Another surgical implication is that diabetics, like any other patient, need to fast before surgery.
If a patient has what is called diabetic gastroparesis, it may result in delaying gastric
emptying and subsequently aspiration after
surgery, pneumonia, and death.
In addition, gastroparesis may result in persistent nausea or vomiting with consequences such as
delaying resumption of oral intake.
There is no question that surgery may also precipitate heart ischemia or attack.
One of the things we all need to look out for is that a patient with diabetes
can actually have a silent heart attack, where
there are absolutely no physical symptoms.
If you have diabetes, it is not a contraindication
of having cosmetic surgery.
It will all depend on your preoperative levels, including HCB 1, as well as other factors
that your surgeon needs to take into consideration before surgery.
You need to have your glucose very well controlled.
As a matter of fact, if you are overweight,you might be one of the 20% of diabetics
who do not even know it.
This is the reason that I always check the glucose in patients who are at high risk
of having diabetes before any cosmetic surgery.
You might be diabetic and not know it.
If you have diabetes that is not controlled, your cosmetic surgery needs to be delayed.
Cosmetic surgery is not a necessary
procedure, so it is important to delay
until blood sugar is controlled.
In addition, if you are diabetic, it is extremely
important that you be the first patient who
has surgery during the day, because fasting
can create de-arrangement
in the metabolism of glucose itself.
This can actually help control and prevent postoperative complications.
It is paramount that a surgeon who understands
your condition do your procedure.
The surgery may be successful, but if preventive measures are not implemented, you can develop
complications like wounds during your stay at the surgical facility or infections after the surgery itself.
Follow my recommendations; good communication
between the surgeon and your primary care
doctor will be essential for you to have a
successful surgery and good results.
In this video, we discussed diabetes and cosmetic
surgery.
Next week, we will discuss how obesity can affect your surgery and increase complications.
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Remember to log on to our Hourglass TV for more information about your surgical procedures.
On Monday we have Bootyman for everything related to buttock enhancement procedures.
Tuesdays: Wonder Breasts where we discuss topics related to cosmetic breast surgery.
Wednesdays we have Star Bodies. If you want to have a star body log on to our Hourglass TV.
Thursdays: Hourglass operating room you’re going to see me doing live surgeries with before and after pictures.
Also Shoddy where we discuss cases that require cosmetic surgical revision.
And Friday SuperHourGlass for topics related to have that Hourglass figure that you want.
And finally live broadcast surgeries every day of the week on Facebook live, Periscope and SnapChat.
All these and more in the Hourglass TV!
