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August 22, 2003

Pills for Diabetes, Surgery

Question from Harrisonburg, Louisiana, USA:

I just found out I have diabetes, but I suspect I have had it for a while. I have numbness in my feet and legs for which I had all kinds of tests several years ago, and a neurologist told me he thought I had a pinched nerve. A second opinion said arthritis in my back, but after reading information on Internet, it seems that it could be neuropathy. I am planning to have surgery on my feet, and I went to a podiatrist but had to have a physical 30 days in advance. I went to my family doctor, and I asked him to do several tests including a blood sugar because I have lots of diabetes in my family. As I suspected, it was high (348 mg/dl [19.3 mmol/L] ), and he put me on oral medication. I can eat only very low carbohydrates and of course not sugar. I have been eating only green vegetables, meat and sugar-free jello, water, unsweetened tea and drinks. I have been checking my sugar fasting and two hours after eating. It is higher in the morning after fasting, and I take the medication in morning after checking my sugar. It has been as low as 103 mg/dl [5.7 mmol/L] in the evening after eating a salad dressing and about eight hours after taking medication. Are there any time-released medications? What about having surgery on my foot when my sugar is under control?

Answer:

There are time-released medications available. Metformin is available as a sustained-release preparation. There are also sulfonylureas and thiazolidinedione thiazolidinediones that are given once a day. You should check with your physician as it may be that you simply need more medication, rather than a time-released drug.

If you need surgery, I would try to work on achieving excellent blood sugar control prior to an elective surgery. This will help you to heal and prevent additional risk of infection. There is the possibility that your sugars will temporarily increase during the stress of surgery. You should check with your physician regarding a plan for this.

JTL

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

WWQ]