Prescribing Safety Assessment (PSA) Practice Exam

When is it advisable to stop oral hypoglycaemics prior to surgery?

1. 1 week prior

2. The day before

3. 4 weeks prior

4. They should not be stopped

The correct answer is: The day before

Oral hypoglycaemics are medications used to manage blood glucose levels in patients with diabetes. It is essential to consider the timing of stopping these medications in relation to surgery to manage the patient's blood glucose levels safely and effectively. Stopping oral hypoglycaemics the day before surgery is advisable because it allows the patient's blood glucose levels to stabilize, minimizing the risk of hypoglycemia during the surgical procedure. This approach ensures that the patient is not at an increased risk for complications that may arise from low blood sugar levels while they're under anesthesia. In the context of the choices, stopping them too far in advance, such as a week or even four weeks prior, could lead to uncontrolled hyperglycemia, making it difficult to manage the patient’s glucose levels leading up to and during the surgery. Additionally, not stopping them at all could pose significant risks during the surgery because the stress response and alterations in the usual metabolic state could further complicate glycemic control. Therefore, halting the oral hypoglycaemics the day before surgery strikes a balance between preventing hypoglycemia and allowing for adequate management of blood sugar levels in the perioperative period.