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Hi,

I am wondering if anyone has (or can point me in the direction of) information or guidelines for best practice in undertaking nail surgery on a paediatic Type 1 diabetic, particulary upper HbA1c range? I have come across a few local policies where the cut off ranges from 8% to 12% but none of those I have had contact with were able to provide evidence on why they settled on the figure they had. I understand that ours was a decision made by our Consultant Diabetologist. As a result I am keen to know what others are doing, how they arrived there and if they have any evidence to support it.

I will be hugely appreciative of any information or suggestions you are able to provide.

Thank you, Shepod

ps. I am mortified I have spelt surgery wrongly in the title but can't work out how to edit it!

 

Young people with Type 1 DM have surgical procedures without fuss routinely. Yes, a wayward HbA1c is of some interest in terms of risk profile for infection, but beyond that there is little reason not to perform a minor procedure of this nature under local anaesthesia if it is indicated. If the patient has always had trouble containing there HbA1c to the desired target, then that just might be they way it is despite the best (or worst) of care.

Professional courtesy suggests inform the treating endocrinologist/diabetologist and family doctor of your plans, and why the surgery needs to be done, in case you need their assistance with a postoperative infection.

Though sometimes multidisciplinary care is sometimes great in theory, but a let-down in reality...

LL

 

Hi Shepod,

:welcome: to Podiatry Arena.

:eek: Been there, bought the T-shirt.

You could try clicking the 'edit' feature at the bottom of your post. (There is only a limited time to edit though). I'm unsure if this will allow you to alter the title.

If you had just posted & not yet had any replies you could delete the thread as the thread starter & started over.

Best regards,

Mandy.

PS. My typos are (usually though not always) reduced by previewing my posts before I submit reply. :empathy: