The goal for all diabetic patients is to maintain their metabolic control as close to normal as possible to prevent the short and long term complications of diabetes. Surgery of any type presents a unique challenge to the diabetic patient because two factors tend to worsen their metabolic control 1) the stress of the actual surgery and 2) the bed rest that follows the surgery. Data has clearly shown that surgery increase counter regulatory hormones (epinephrine, glucagon, growth hormone and cortisol). What has not been studied is the effect of bed rest per se on metabolic control. This is surprising because there are many studies in normal healthy people demonstrating that simple bed rest increases insulin resistance and worsens metabolic control.