I'm going to have knee replacement surgery and will be in the hospital for a few days. Will I need insulin there? I am type 2, diagnosed 4 1/2 years ago. I have no meds — just diet and exercise. My A1C is 5.8 and hasn't been above 6 since I was diagnosed. I don't want to go on insulin or other meds if I don't have to. Thanks.

Dr. William Sullivan


As you know, any stress including surgery, infection or certain medication (such as steroids) can cause an elevation in blood glucose levels. The fact that your diabetes control is excellent, with an A1c of 5.8% on diet/exercise alone, indicates a good prognosis with surgery. Often, if diabetes control is excellent prior to surgery, especially with no medications, surgery such as knee replacement goes very well with regard to diabetes control. It will be important to have your glucose levels monitored closely after surgery, as good diabetes control is important for the healing process after surgery. Although the need for insulin may not be likely in your case, temporary use of insulin after surgery can be very helpful to keep blood glucose levels within goal. You should review your blood glucose goals after knee surgery with your healthcare provider.