I had my endo request IV insulin for me during surgery (NOT knee replacement, but invasive), and communicated this to surgeon. It wasn’t communicated to hospital well (anesthesiologist), but in the end, I was able to have IV insulin and glucose though surgery and first 2 days after (i don’t remember much, mega pain meds). They did fingersticks frequently, and adjusted.
Then I had to sign papers to refuse insulin injections by staff, and that I would manage insulin with my pump the next 4 days in recovery, and they removed IV insulin. I also used dexcom during recovery.
For pain management, I made sure no Tylenol, due to interference with dexcom.
Ironically, 4 days after release, I was admitted again via ER visit, and received additional treatment (no surgery) and 3 day stay. Kept my pump and dexcom the whole time, and they completely ignored that I had diabetes, and I had full management.