Cancellation for hyperglycaemia

45-year-old man planned for cystoscopy and retrograde pyelogram


  • IDDM – Type 1
  • ESRF – haemodialysis
  • Uncontrolled hypertension
  • Cognitive decline – multiple CVA’s
  • BKA 2018


  • Cancelled on day of surgery – BSL = 27mmol/L
  • Regular insulin and antihypertensives had been withheld on morning of surgery


Could this have been prevented?

  • Phone consult undertaken – difficult due to cognitive decline
  • Webster pack reviewed and medications charted accurately
  • Insulin not documented on webster pack form and missed
  • Phone call from day stay to patient the night before. Patient asked about insulin, told towithhold as nothing documented in notes
  • Very easy mistake to make during difficult phone consult
  • Need to check separately for injectable medications, inhalers, anticoagulants, and aspirin
  • Prolia (denosumab) commonly forgotten by patients as is 6-monthly injection.
  • Perioperative management of medication guidelines
  • If in doubt about perioperative medication, can discuss with prescriber