Postoperative recovery for people with diabetes is a “marathon” 

Surgery puts a major strain on the body, physically. The problem, however, becomes even bigger for people who are fond of sugar. Just that, hyperglycemia is a hotbed of postoperative infection that impairs the activity of white cells, thus enabling bacteria to multiply and raising the risk of infection. At the same time, having an unsteady blood sugar level can also severely impact the condition of vital organs such as the heart, brain, and kidneys. Blood glucose stabilization, therefore, is the basis of the defense against postoperative recovery.

Postoperative nutrition for people with diabetes

Not simple “eat and drink well”

Then, what should people with diabetes do in order to heal their wounds effectively after surgery?

As a matter of fact, wound healing is like the construction of a house, which requires abundant “building materials”. Proteins are the “bricks” used to build walls that are made up of the body’s new tissues, and without proteins, wounds do not heal and the immune system becomes weaker; vitamins and minerals are the “cement workers” who bond “bricks”, in particular vitamin C, zinc and iron, which are directly involved in collagen synthesis and cell proliferation; Energy (mainly carbohydrate) is the “wage of the construction worker” that powers the entire restoration process. Nevertheless, this “salary” should be paid in due time and in a quantity that is not too little (leading to the worker’s lack of strength) or too much at once (leading to a blood sugar mix-up).

If we understand these well, we shall have the general scheme of providing the body with high-quality, enough and readily absorbable “building materials” while maintaining strict blood glucose control. Consequently, the nutritional rehabilitation of diabetics after surgery is not at all the simple “eating and drinking” but a “precision nutrition campaign” that has been carefully planned.

Indeed, this “campaign” has only two main goals: to keep blood glucose levels stable and to facilitate the healing of the wound.

To keep blood glucose stable means to avoid both hyperglycemia and hypoglycemia as well as to provide tissues with a good healing environment (e.g., hyperglycemia can bring about a drop in the activity of white blood cells and cause infection risk to rise). Prohealing is to provide the body with enough and good-quality food, especially protein, vitamins, and minerals.

What should be done by the doctors and nutritionists according to their respective individual protocols should be carried out with maximum adherence from the patients. Postoperative medication (insulin or oral) might be altered and this has to be done in a coordinated way that is closely followed.

The three meals a day dinner is replaced by 5 to 6 meals (three main meals＋2 to 3 extra meals), which effectively controls the peak blood sugar after a single meal and lowers the burden on the pancreas. The time of injections and intake of food in the case of insulin-injected patients should be stable so as not to suffer from hypoglycaemia. Monitoring should be increased in the blood glucose fluctuates greatly during the postoperative recovery period (before meals, 2 hours after meals, and before going to bed) to provide a basis for dietary and medication adjustments.

Stage one: Fluid diet period

Fluid diet period

(In the early stage, 1 to 2 days after surgery)

Clear soup: Removing oil from chicken soup, fish soup, broth/spare ribs soup (drink only soup, do not eat dregs), skim off oil slick, remove foam, thicken without starch.

Sugar-free vegetable soup: filter out the vegetable residue.

On the other hand, there exist few options of the special enteral nutrition preparations stage for diabetes the best option at this stage. Diabetic-friendly, slow-release energy formulations with balanced nutrition and a gentle blood sugar response, custom-tailored by a nutritionist should be chosen.

Guide to avoid pitfalls: Do not consume milk, soy milk, juice (containing residue), thick soup, etc. that can stimulate intestinal gas production and make the stomach distend. Following the principle of “small amount and multiple times”, 50~100 ml (1/4 to half cup) should be taken once every 1~2 hours. Do not consume in large amounts at once.

Stage two: Semi-liquid diet period

(Transition period, 3 to 5 days after surgery)

Milk, soy milk: Initially with a small amount to be observed for abdominal distension.

Yoghurt: Select sugar-free or low-sugar yoghurt that is not only rich in protein but also enriched with probiotics, which are beneficial for gut health.

Egg drop soup, steamed custard: the most comfortable protein of high quality, the texture is soft and easy to digest.

Protein Powder: Doctor-accompanied whey protein powder can be mixed into a liquid diet.

Porridge: rotten rice porridge, millet porridge, oat paste (extremely soft cooking).

Mashed potatoes: mashed potatoes, yam (in a small amount, to replace some of the staple foods).

Fruit and vegetable puree: pumpkin puree, carrot puree, banana puree (note that bananas are sweeter, appropriate amount).

Guide to avoid pitfalls: Do not consume high crude fiber foods such as mixed beans, brown rice, etc., in order not to aggravate the intestines. All foods should be beaten into a uniform paste with a yogurt-like texture through a blender. It can be increased to 200~300 ml per meal, 5~6 meals per day.

Stage three: Soft-food period

(Recovery period, 1 to 2 weeks after surgery)

1/4 high-quality protein: Rotten, tender meat for selection. For example, steamed fish, steamed eggs with minced meat, minced chicken, mashed liver, tofu, dried tofu, etc.

1/4 high-quality staple food: Soft and rotten grains for selection. For instance soft rice, rotten noodles, small ravioli, small dumplings, whole wheat bread (eat after soaking in soup or milk).

1/2 non-starch vegetables: Soft-boiled vegetables to be selected. For example, winter melon, spinach leaves, pumpkin, tomatoes (peeled). Remember to eat enough vegetables, rich in dietary fiber to help delay blood sugar absorption.

Extra meal: one extra meal each in the morning and afternoon. Choose from a small cup of yogurt, a few slices of soda crackers, half an apple (scraped into puree), a handful of powdered nuts.

Guide to avoid pitfalls: The main cooking methods are steaming, boiling, stewing, and braising, etc., while frying, etc., are prohibited. The dish should be softer than usual. Be careful of dishes you like to be braised, sweet and sour, which can have a lot of sugar and oil. Chewing well can reduce the gastrointestinal burden, help to increase the feeling of satiety and stabilize blood sugar.

Stage four:

Gradual transition to a general eclipse

(Comprehensive nutrition period, 2 to 4 weeks after surgery and beyond)

Staple food thickness matching: Slowly add whole grains such as oats, quinoa, and brown rice, but start with a small amount to make sure that the intestines can adapt.

High-quality protein guaranteed: Fish, poultry, eggs, meat without much fat, soy products, etc. should be consumed sufficiently every day.

Consuming colorful vegetables: More than 500 grams of vegetables should be eaten every day, the richer the color, the better.

Eat “good” fruits: Low-GI fruits (such as apples, pears, peaches, strawberries, grapefruits) are the fruits to be selected and eaten as extra meals between meals, each measuring about the size of a fist.

Moderate amount of healthy fat: e.g. a small amount of nuts, olive oil or camellia oil, etc.

Light cooking: Keep using healthy methods such as steaming, boiling, and quick-frying.

Eat regularly, regularly and quantitatively: the most powerful way of blood sugar stabilization.

Postoperative recovery for people with diabetes Is a “marathon”

The road to postoperative recovery in people with diabetes is a “marathon” that is driven by nutrition, not a sprint. Nevertheless, besides nutrition, the following actions should also be done.

Blood glucose monitoring is “navigator”: Increase the monitoring frequency in the early postoperative period (such as before three meals, 2 hours after three meals, and before going to bed), record diet and blood glucose values, thus facilitating the finding of the best balance between diet and medication by you and your doctor.

Moisture replenishment should be adequate: sufficient moisture is good for metabolism and wound healing. Unless the doctor has given some restrictions, you should drink 1.5~2 liters of water per day. Boiled water and light tea are the best choices.

Communicate closely with the medical team: attending physicians, nutritionists, and diabetes specialist nurses are the strongest support groups for people with diabetes. Any dietary questions and adjustments should be communicated with them first.

Vigilance “hypoglycaemia”: During the postoperative convalescence period, changes in appetite and adjustments in dietary structure may lead to hypoglycaemia. Know well the symptoms of hypoglycemia such as palpitations, shaking of hands and cold sweats and always keep emergency foods such as biscuits and candies with you.

Patience and Confidence: Recovery is a step-by-step process, and don’t be anxious because of temporary blood sugar fluctuations or loss of appetite. Be positive and patient with your body, which is under your careful care.

Disclaimer: The following image/content has been generated by an Artificial Intelligence model and is not a photograph or a traditional human creation.