Surgery/managing pump and Dexcom

I’m having surgery for diverticulitis on March 12. They will remove a small portion of my colon and reconnect it (if all goes well). The surgeon says it may take from 3 to 6 hours. If I want to wear my pump through surgery, and the anesthesiologist is ok with it, then where do I wear it? The surgeon says that all my of my front from below my breasts needs to be available to him. Also, they may be doing something on my thighs, so not to wear my infusion set there. I am overweight, so I have enough fat to wear the set above my breast, next to the armpit. I’m going to try my next set there, to see if it works. But where would the pump go? Do I hang it from my neck? Has anyone gone through this?
Also, maybe my Dexcom sensor can go in in the same area? They probably won’t use my Dexcom readout during surgery, but I want it available as soon as I can use it. Please let me know your experiences, and solutions you have found. This has me somewhat worried. Thanks!

Following. I’m having GI/abdominal surgery on 3/26. Figuring I can keep wearing my G6 on my arm and hoping I can keep wearing my OmniPod on my upper pec.

First good luck with your surgery. It is always a scary prospect.
I did 5 surgeries for a clinical trial. My CGM was on the back of my arm and my infusion set was on my upper buttocks area on the opposite side they were going to be working on. The devices were planned on going in just above the belt line in my back. But when I woke up the had put them in the lower front abdomen area at the belt line. I was the first women and they had to make adjustments. But you know where this is going to happen.
So maybe that space above the belt line. The other place I use is my under arm where that skins hangs. I would try for both pieces I. The same area so BP cup can be on the other arm.
And I am thrilled they are letting the pump stay on and they should be all over that CGM. Every surgery I have had, I handed the CGM receiver off to the doctor handling the anesthesia. That little tool will make everyone’s life so much easier.
Again, good luck!

Try the areas that you were mentioning. With the two surgeries that I have had I set my temp basal at 50% of normal. You will probably be a little high but correct the BS to get it back to normal. The surgery team monitored by BS during the surgery and after the surgery. Better high then low. Good Luck.

I had a similar surgery several years ago. I knew I would be very medicated the next days after. So my surgeon (and support from endo) agreed to my insulin via IV infusion along with the other meds I was getting.
This worked well for me. I wasn’t eating until 3rd day, so IV was giving both glucose and insulin.
When I was able to eat, they stopped the IV glucose and insulin, and I just got fluids and pain meds via IV, and then started using insulin pump. Of course I needed to sign waiver once I did my own insulin dosing via pump, and had to show them what I was dosing for their records.

No metal was allowed during my surgery, so I removed dexcom, but had family that put new one in after surgery. They monitored my BG during surgery via fingersticks.

Did you have them do some amount based off of your basal rate? I’m T2 and was getting virtually nowhere with Levemir and am so much better controlled with my OmniPod. I don’t want to go back to injections even for the week in the hospital.

I gave them my pump settings. They were able to control rate of insulin and changed as needed, but intentionally kept me around 150.

When in recovery, they tested BG, ran a calculation, and adjusted IV flow if needed, about once/hour. But I slept through most of that !

1 Like

I would have the doctor “managing” your pump (in other words the one that signs off on the orders for your pump) speak to the surgeon and discuss where potential site options. They can compare notes and get an idea of possible sites that will work but be out of the way.

While I haven’t had abdominal surgery, I have had several surgical procedures. First, ask your doctor if he will sign off in your chart (once you get to a room) that you, and you alone, are to manage your diabetes, that no one is to shut your pump off, and that you are to manage your own testing and boluses. This is important because, sadly, it is still not uncommon for some hospitals to refuse to allow you to keep your pump going, and in-hospital they don’t manage bg’s very well.

Second, if you’re going to have a gown tied around your neck, you can hook your pump from there. That’s what I did, and it didn’t interfere at all with the anesthesia management. As I said, I didn’t have abdominal surgery but, even so, if you’re having general anesthesia, which I imagine you probably are, you’ll have a breathing tube during the surgery…but none of my anesthesiologists complained about the pump, and they’re the ones who are managing things around your head/neck area.

Best of luck with the surgery…hopefully all will go smoothly and you’ll be feeling much better afterwards.


My pump basal is pretty constant throughout the day under normal circumstances. So they used that as starting point (.6 u/hr). But they adjusted as necessary, since they could control both glucose and insulin flow via IV.

I didn’t worry about higher bg during surgery, just wanted to prevent lows. So did they.

When they first stopped insulin IV, I hooked up my pump, running just basal. But didn’t account for glucose that was still in IV drip. So as soon as I could eat, they stopped the glucose. So make sure you know what is in IV if you go that route.
If you are using your pump and go low, confirm they would have IV glucose to raise it.

Your case may work better by using your pump instead of IV insulin. That was not an option for me during surgery. But do check if they would do IV glucose in case of low, or for you to adjust your basal if they planned on constant IV glucose during the surgery.

1 Like

For abdominal surgery? Wear it around the neck maybe… :rofl:

Haven’t gone through surgery of any kind, but my wife is an anaesthesiologist and regularly has to manage her patients’ pumps. Wearing your infusion site above your breast would be perfect, and you could clip the pump to the collar of your gown prior to surgery. The anaesthesiologist will be sitting at your head end as they will be managing your airway, so it will be nice and accessible if they need to do anything on your pump.

Good luck with your surgery!

You do hope they use the CGM to read your BG levels. I didn’t have one a few years ago when I went through surgery and the first surgery was short, less than 30 minutes, but I came awake in the 70’s in recovery.

The second time I reduced my basal in half and was going to be in surgery for about 3 hours. So a little more concerned about my levels. I asked the anesthesiologist how often they check and he replied usually just when they first start. I told him I had dropped the week before and could he check my Bg level half way through and he agreed. This was a teaching hospital and pretty well known. That was scary. I ended up coming out of surgery at about 150…

From having discussions with other people, hospital care of Bg levels can really vary.
There is some discussions about using pumps on this thread.

I’ve found that the surgery and the lack of bolusing for a non-existent breakfast, obviates the need for me to reduce my basal. If a more extensive surgery (knee replacement, for example), my bg’s run very high for a couple of days so I need to pump a lot more insulin than normal.

1 Like