I am 46 years old and have type 2 diabetes. I am having Achilles tendon surgery in two days and my blood sugars have been in the 200s mg/dl [11.1 mmol/L to 11.1 mmol/L]. I am concerned about infection and being in a cast for three to five months and I won’t be able to do any exercise. My most recent A1c was 8.8. I take Avandia, 8 mg a day, and glyburide and the levels don’t come down much. What can I do to get my levels lower and what exercise can I do while being on a cast? How much food should I eat during the day as I will be sitting? I would appreciate a quick response as I am so fearful.

The most important thing is to make sure that you test regularly and keep your physicians aware of the blood sugars. Because you will be using fewer calories, you will have to decrease your food intake. While you are at the hospital, you can talk to the dietician about how to do this. That service should be easily available to you. There is the concern that the blood sugars will not be good, even if you cut your food appropriately as your A1c is still fairly high. In that case, there is the possibility you might need insulin for a short time until you are back and more active. You may want to talk with your physician and see if you can do some lifting with hand weights from a chair. Some exercises are better than none.

JTL