Patient Selection for Diabetes Surgery


First Step

First Step to check if you can be considered for this surgery.


1st Step Selection Tests----
Blood tests--



  1. Measure the Blood Glucose, C-peptide & Se. Insulin in Fasting state, and again at 60 mins after drinking solution with 75 gms Glucose (plus small piece of cheese if possible). [No Insulin that morning & no Lantus Insulin the previous night; usual Tablets can be taken]

  2. Se. Glucagon Fasting

  3. HbA1c

  4. Se. Lipids

  5. Urine for Micro-albumin

    GAD antibody, Islet-Cell Antibody (ICA) & Insulin auto-antibody (IAA2) tests will be done if required

2nd Step

A Clinical (physical) exam will be done, foll. by an exhaustive list of investigations and anesthesia fitness, before you can be taken up for diabetic surgery.


Investigations:



  1. Complete Blood Picture

  2. Fasting Blood sugar

  3. HbA1c

  4. Fasting Se. Insulin

  5. BUN

  6. Se. Creatinine

  7. Prothrombin time, BT & CT

  8. Liver function tests

  9. Lipid profile

  10. Se Uric Acid

  11. Se. Iron

  12. Se. T3, T4, TSH

  13. Se.HbsAg, HIV, HCV

  14. Se. Vit B-12

  15. Se. Calcium

  16. 25 OH Vit D3 

  17. Se. PTH

  18. Se. Cortisol- Fasting

  19. C- Reactive Protein

  20. Blood group

  21. Urine routine

  22. X-Ray chest PA

  23. ECG

  24. Pulmonary function tests

  25. 2-D Echo

  26. Colour Doppler for  Lower limbs (venous )

  27. Ultrasound exam -Whole abdomen

  28. UGI Endoscopy with Rapid Urease test (RUT) with IV Midazolam

3rd Step

Admission into hospital 1 or 2 days before surgery, according to anesthetists advice.
Liquid diet for 2 days