I really need skin reduction surgery, but worry about risks due to dm and high bp?

Discuss with surgeon. This needs to be individualized. Discuss with plastic surgeon who does procedure frequently and also discuss with primary physician whether you can be cleared medically for procedure.
Optimal med control. The first thing is to obtain optimal medical control of your diabetes and blood pressure to lower your risks of surgery. Other risk factors include obesity and tobacco use. Discuss with surgeon in. Co saltation with your primary care physician.