Type 2 diabetes and waiting for a shoulder replacement. The surgeon wants my sugars down before he will book it. Has anyone else had this?

Retired postman, 66, right shoulder gone, which after forty years of carrying a bag on it surprises nobody. X-ray and scan say worn out joint, cuff mostly intact, so I am told it is a total not a reverse. All fine so far.

The snag is I have had type 2 diabetes for about twelve years and I have been, I will be honest, a bit casual with it lately. Pre op bloods came back and the surgeon said he is not booking a date until my long term blood sugar number comes down, and the nurse mentioned a target. Gave me a real wobble. My first thought was that it is an excuse to push me down the list.

Is this a normal thing? What is it actually about, the wound, the anaesthetic, infection? And did anyone with diabetes find the recovery itself different?

Not an excuse, mate, I promise. My brother in law had exactly this before his knee. They held his op for about three months while he got his numbers down with the diabetes nurse, and he says now he is glad they did. Nothing to do with the queue, everything to do with what happens after.

I don't have diabetes so I can't speak to that part, but I sat in the pre op clinic next to a lady having the same conversation and the nurse put it in one sentence that stuck with me: high sugar slows healing and feeds infection, and an infected replacement is the thing everyone is working hardest to avoid. That was the gist.

glenn_postie said:

My first thought was that it is an excuse to push me down the list.

Glenn, I can't give you anything on the diabetes side clinically, I am a patient not a doctor, but I can tell you why the question gets asked and where the site has written about it, because I asked the same thing about my own blood pressure before my reverse.

The short version is the one reverse-at-68 heard. Infection is the complication surgeons fear most with any joint replacement. It affects roughly 1 in 100 primary shoulder replacements, and a deep infection around the implant can mean further surgery, sometimes taking the whole thing out. Poorly controlled diabetes is one of the recognised things that raises that risk and slows wound healing, so pre op teams commonly set a blood sugar target to bring the risk down before the date is fixed. It is the same logic as asking smokers to stop. The site's piece on shoulder replacement infection covers what it involves, and am I a candidate for shoulder replacement has the wider picture of general health and fitness for surgery.

What the target number is for you, and how quickly it is realistic to get there, belongs with your GP practice or diabetes nurse and the pre op team. They set it, they can tell you what counts as good enough, and they will want to know about your medication around the day of surgery too. Take the delay as the first part of the operation rather than a refusal.

I had a different number held over me, my heart, at 79, and I felt exactly as you do at first. In the end the waiting bit was a few weeks and the anaesthetist was far happier on the day. Use the time for the home sorting, honestly. You will be glad of it.

Update. Saw the diabetes nurse, tablets adjusted, and I have stopped pretending biscuits are a food group. Repeat bloods in December and if it is where they want it they will book me for the new year. I am less cross about it than I was. If nothing else the surgeon has done more for my diabetes in a month than I managed in two years.