Hair transplant in patients suffering from Diabetes

Hair Transplant
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Hyperglycemia and Hypoglycemia are relatively easier to diagnose. It is advisable to do blood sugar level tests at regular intervals during the procedure of Hair Transplant.

This should be done even for non diabetic patients who have strong family history of diabetes.

Hypoglycemia:-

Causes of Hypoglycemia –

The commonest cause of hypoglycemia during hair transplant surgery would be over dosage or bolus administration of insulin.

Hypoglycemia is a true medical emergency, which requires prompt recognition and treatment to prevent organ and brain damage.

Symptoms:

Early symptoms of hypoglycemia may include:-

Confusion, dizziness, palpitations, hunger, headaches, irritability, pounding heart, racing pulse, pale skin, sweating, trembling, weakness and anxiety.

Without treatment more severe hypoglycemic symptoms may develop including:-

Severe headache, poor coordination, poor concentration, numbness in mouth and tongue, passing out, nightmares or bad dreams and coma.

Since the patient is often under sedation during hair transplant, most of the early signs may be missed unless the doctor and technicians are diligent.

It is advisable for hair transplant centers to also have pulse oximeter, which can be easily used to keep a tab on the pulse and oxygen saturation levels on a continuous basis. This simple and inexpensive tool should also be a part of every hair transplant centre.

Treatment

Oral intake of glucose - The blood glucose can usually be raised in minutes with 15 – 20 gms of carbohydrates. It can be given as food or drink (fruit juice, non diet cola etc., 120 -150 ml), or one slice of bread or about 1 serving of more starchy fruits.
However, over treatment should be avoided. It is important to remember that symptoms will begin to improve within 5 – 10 minutes but full recovery may take 10 – 20 minutes. Also, adding fat or protein at this stage will retard digestion of glucose. Over treatment in form of giving higher quantities of glucose will not speed up recovery. It will mainly lead to hyperglycemia that will again have to be treated.

In case patient cannot consume orally then intravenous glucose may be required. It is advisable to administer a solution containing dextrose and saline.

In rare cases, glucagon hormone may have to be injected.

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You know what I find perplexing about those that become diabetic is that they follow the exact dietary pattern that most likely gave them diabetes in the first place. So they keep spiking their blood sugar and since their pancreas is now burned out they need to inject insulin. Both hypoglycemia and hyperglycemia can be completely avoided by simply making dietary changes but most doctors do not have any knowledge in this area. They are in the business of only knowing what they know and what they know it determined by those behind the scenes that profit off of the disease and most doctors don’t even know that.

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Hyperglycemia

Diabetic patients control their blood sugar levels by exercise, regulated food intake, oral medications and/or insulin. During a prolonged hair transplant procedure for example FUE/FUSE procedure lasting over 4 -5 days the patient may not be able to have sufficient exercise to lower the blood glucose levels. Similarly, the stress of actual surgical incisions and patient’s mental anxiety could lead to hyperglycemia even while the patient is administered his/her regular dosage of medicine.
In a hair transplant surgery, patients would usually require a higher level of treatment. For example – a non diabetic patient with family history of diabetes may need oral hyperglycemic drugs, while another patient of Type II diabetes whose blood sugar levels are within normal range by oral hypoglycemic drugs may need insulin during and few days after surgery.

Symptoms:
Signs of hyperglycemic in patient undergoing hair transplant would include headaches, difficulty concentrating, blurred vision, frequent urination, fatigue (weak, tired feeling). Since the patient would be under sedation most of these symptoms could be missed.
Regular blood sugar level monitoring is, therefore, very important. The diet the patient is given during the procedure should also be carefully considered and monitored.

Treatment:
Many diabetic patients are notoriously against insulin injections. Therefore, before the start of the surgery they must be advised that even if they do not need the insulin injection during the normal course of life, Insulin administration may be required during the procedure and their consent to the same should be taken before the procedure.

Regards,
Dr. A