I have type 2 diabetes, high blood pressure, and elevated cholesterol. In addition, I have cataracts, both knees are scheduled to be replaced, and I am having foot surgery in two weeks for 4 separate things. I am in great pain with the knees and feet and my sugar is crazy. Could the pain be the problem? I have increased my medications (Glucotrol and Glucophage). Should I keep this time or change? What can I expect with my sugar during the Roux Y Bypass? How often will I need to test before and after?

Blood sugars usually worsen with the surgery. Currently, you are on Glucotrol [a pill for Type 2 diabetes] and Glucophage [metformin]. If you are not having good control, you need to speak to your physician about using insulin. It is also of benefit to have your sugars in good control surrounding surgery to allow for good wound healing and the prevention of infection. Pain can worsen glucose levels, especially if severe.

JTL
Additional comments from Dr. Bill Quick:

It is recommended that Glucophage be discontinued several days before scheduled major surgery, to avoid any risk of developing lactic acidosis. As such, you and your physician ought to work out a plan to control your diabetes during the surgery and the post-operative period, probably with insulin. By the way, if insulin is initiated under these circumstances, it might well be possible to discontinue it post-op, especially if you are then in less pain and able to be more active.

WWQ

[Editor’s comment: See Surgery Pre-Op Advice for some additional thoughts.

SS]