My Blood Sugar level has increased since quitting smoking; what is the max H1C level is it safe to have surgery?

I'm 48 days Pre-OP and 3 weeks before my Pre-op appointment, I quit smoking 39 days ago and my sugars have increased. I am a borderline diabetic, I'm doing my blood work in 2 weeks and I'm afraid the surgeon is going to tell me its not safe. I have been watching what I eat and go for short walks multiple times a day... will this help? since quitting smoking I have only gained 4 or 5 pounds. I started taking Flaxseed oil and magnesium to try and help.... Any other suggestions?

Doctor Answers 4

Borderline diabetic with increasing sugars pre op

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Hi GA_FL_Girl

The H1C tends to measure blood levels over time.  As doctors, we like to see that the blood sugars are well controlled, and the H1C is a good indicator overall.  The H1C doesn't give spot blood sugar checks.  

I would recommend that you visit your internist and discuss your surgical plans.  Perhaps you have crossed over from borderline to diabetic.  It may be a good idea for you to get on a sugar reducing med like Metformin. Keep your surgeon informed.

All the best.


Face lift - blood sugar up but smoking stopped. Am I safe for surgery

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Thank you for asking about your face lift surgery.

  • Congratulations on not smoking! Yeah for you.
  • I suggest you ask your surgeon or regular doctor to do an HGA1C on you now.
  • If your sugar levels have raised the A1C above seven, there will be time to bring it down before surgery.
  • Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Diabetes, Blood Sugar Control, HgBA1c, and Plastic Surgery

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Congratulations on stopping smoking! That's great news and you should be very proud of yourself. You shouldn't be "afraid" but relieved and grateful that your plastic surgeon wants you to have the safest possible procedure. Poor blood sugar control leads to increased complications. Number one on that list is poor incision/wound healing and skin death/necrosis. No one wants to go into ELECTIVE plastic surgery eventually needing RECONSTRUCTIVE plastic surgery because of wound healing problems caused by poor blood sugar control. Suggestions would be to consult with your primary care doctor ASAP for tighter glucose control and to keep a food journal to really monitor what you're intaking in terms of food type and amount. You may even want to weigh your food to give an accurate accounting of the amount you're truly eating. Exercise is definitely a plus. Keep that up and good for you! You may want to increase the intensity if okayed by your regular doctor. Every surgeon will have different criteria for the HgBA1c, but in general a HgBA1c under 7 is the goal. Some surgeons may even be more strict than that. You should also alert your plastic surgeon earlier than later. A cancellation too close to surgery may result in a cancellation fee. Perhaps s/he can help you get your blood sugars under control sooner. The goal of getting your blood sugar under control should be for improved longevity and quality of life, not just temporarily for plastic surgery. Best of luck!

Hemoglobin A1C values over 7 are associated with surgical infections and other problems

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It is good to see a patient doing their best to improve their health situation as your are. I hope you can eventually have your surgery and have it without any complications related to diabetes. In the medical literature, HgA1c values over 7 have been associated with infections and other problems, so that seems to be a reasonable cutoff in my mind. However each surgical practitioner is going to have different assessment of risk in each individual patient they are treating, so please share your concerns with your surgeon and listen to his concerns for your individual case.

I feel that pre-operative exercise (cardio) is of great help in ensuring a good recovery from surgery. So I would encourage you to continue your walking, aiming for 4-5 sessions of 30 minutes each per week. It is also important to make sure you are walking briskly to get your heart and breathing rate up. Leisurely strolling is better than nothing, but surgery is a stressor on the body - patients that are fit and used to experiencing physiological stress from their exercise always seem to do better after surgery with an easier recovery in my experience.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.