Sedation of diabetic patients is managed by allowing the patient to take a light breakfast and ending the appointment in advance of lunch so that the patient can maintain their blood sugar. A significant number of type-2 diabetic patients have undergone some form of bariatric surgery to manage their condition. How does this affect the sedation appointment? DOCS Education faculty weigh in.

A DOCS Education member writes in:
We will be sedating a 49-year old female with type-2 diabetes. She had gastric bypass surgery 15 years ago, and her blood sugar is well-maintained. The patient stated that oral sedation medication metabolizes much quicker in her system as a result of her surgery. Are there any recommendations or new protocols for this patient?

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Dr. Jerome Wellbrock, DOCS Education faculty member, responds:

Sedation pharmacodynamics depend on the type of gastric bypass she recieved. If she had a Roul-EN-Y or gastric sleeve surgery, then the medications will pass through more quickly, so you may see a faster onset of sedation but a shorter period of sedation since the meds keep moving and are not as well absorbed. If she has a Lap-Band then the meds will pass through more slowly so you may see a longer onset time but longer duration of sedation. My advice is to use an incremental protocol and depending on her gastric procedure you will have to adjust your dosing frequency.

Disclaimer

The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.

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The information contained in this, or any case study post in Incisor, should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 3250 Airport Way S, Suite 701 | Seattle, WA 98134. Please print a copy of this posting and include it with your question or request.
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