Your diabetes medicines are usually adjusted before surgery, and some are stopped on the day of surgery. Oral diabetes pills and noninsulin shots, including metformin, GLP-1 medicines, and sulfonylureas, are typically stopped on the day of surgery. SGLT-2 inhibitors are usually stopped 24 to 72 hours before surgery. If you use insulin, the plan depends on the type. Long-acting basal insulin is often reduced the day before or the morning of surgery, and short-acting insulin is usually held when you are not eating.

A few common patterns are:

• Long-acting insulin, often reduced by about 20% to 25%.
• High-dose basal insulin, sometimes reduced by 50% to 75%.
• NPH or premixed insulin, often reduced by 50% the morning of surgery.
• Short-acting insulin, usually no morning dose if you are NPO, meaning not allowed to eat or drink.

Your team will also want to know about all your diabetes medicines ahead of time, because some can affect stomach emptying, blood sugar, or surgery safety. Blood sugar is usually checked before surgery and during surgery, and insulin may be given by the anesthesiologist if needed. Verify the exact plan with your surgical or anesthesia team in case they want something different for you.