Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Robotic Hernia Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
In short
Diabetes is common in Ahmedabad and it turns up in a large share of hernia clinics. It rarely stops the operation. What it changes is the timing and the care taken around the wound.
The reason is straightforward. Sugar that sits high slows the cells that close a wound and weakens the body's answer to bacteria.
A single morning reading tells you about that morning. HbA1c tells you about the last three months, which is the same period in which the wound has to heal and the mesh has to settle in.
For planned surgery most units look for a figure under about 8 percent, and nearer 7 is better. Above that, the usual advice is to take a few weeks and bring it down.
What is checked, and what it changes
| Check | Why it is done | What it changes |
|---|---|---|
| HbA1c | Shows the average sugar over three months | Above about 8 percent, a planned repair is usually postponed |
| Fasting and post-meal sugar | Shows the day-to-day swing | Guides the dose plan for the day of surgery |
| Kidney function | Diabetes affects the kidneys over time | Changes which painkillers and antibiotics are safe |
| Wound and skin check | Looks for infection near the operating field | Any active skin infection moves the date |
| Medicine list | Some drugs are held before an anaesthetic | Written instructions for tablets and insulin |
Not sure whether your sugar control is good enough for surgery yet? Bring your last reports to the first visit.
People with diabetes often ask whether mesh is safe for them. It is. The chance of an infection reaching the mesh is higher than in someone without diabetes, but it remains low for a planned keyhole repair.
The controllable part is sugar, along with stopping smoking and treating any skin infection near the groin or the navel before the day.
A long open wound in a person with diabetes is the part most likely to give trouble. Keyhole and robotic repairs use several small cuts instead, and the skin closes faster.
That is a preference, not a rule. A very large or scarred abdominal wall may still be better served by an open repair, and that call is made on the wall, not on the sugar.
Warning signs to report after you go home
Sugars often run higher for several days after any operation. That is the body's response to surgery, not a failure on your part. Doses are adjusted and then brought back down.
Keep the wound dry, keep walking, and go back to your usual diabetes routine as soon as you are eating normally.
Most units want it under about 8 percent for planned surgery, and nearer 7 is better. An emergency is different, because the hernia decides the timing, not the sugar.
The risk is higher than in someone without diabetes, but it is still low with planned keyhole surgery and good control. Poor control is the part that can be changed.
Usually not. Most oral tablets are held on the morning of the operation and insulin is adjusted. You will be given written instructions for your own medicines.
Often, for a few days. Surgery itself raises sugar, and so does eating differently. It is checked in hospital and the doses are adjusted if needed.
For a planned repair, usually yes. A few weeks of better control lowers the wound risk. A hernia that is stuck or painful is not delayed.
The main page on this site is robotic hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Shah's Gastro, Cancer & Robotic Surgery Centre
Apollo Hospital, Bhat, Gandhinagar
Gota OPD, Ahmedabad
Bring your reports. Second opinions are welcome.
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