The Gastric Sleeve And Diabetes

[IMKRISTY 1]

I thought I would post this topic on the post-op section because I would like to hear personal stories of people who have had diabetes and got the sleeve, and what the outcome was.

I have talked with my nurse and she keeps telling me that I should get RNY instead of the sleeve because of my diabetes (Mind you, they very rarely, if at all, do the sleeve at the hospital Im going to). I cant help but feel that the sleeve would be a better option for me for several reasons. I have no desire to have my intestines messed with and with having 75 to 80lbs to loose, I cant help that both the RNY and the DS would be an overkill for me. i could be totally wrong and would really appreciate any feedback I can get to help with my decision. If everyone tells me that RNY is the way to go to help with my diabetes, then that is what I'll do, but soemthing keeps telling me that isnt right. I just want to make the best decision to get healthy.

[*susan* 1,709]

I am not a diabetic, so I can't really give an educated answer on this. I can tell you just prior to my surgery, I was borderline diabetic, and since the surgery, that is no longer an issue.

As far as surgery choice, you need to pick which one you are comfortable with. Do not let anyone push you into something if it is not what you want, not even a physician. Get a second and/or third opinion if need be. This is your life and your body, you own it, no one else does. Therefore, the final choice in what is done to your body, especially when it is a permanent one, needs to be yours and you need to be comfortable and happy with that choice.

[Shellyac 22]

Based on a position paper by the ASMBS in their review of studies on patients that have had the sleeve they found that at a little over a year after surgery 66% of the patients had their diabetes resolved and another 27% had their diabetes improved. My original surgeon also tried to get me to have the bypass because of it's track record of resolving diabetes she also mentioned that they are preforming the bypass on non-obese diabetics because of it's ability to help improve diabetes. I think that regardless of which procedure you decide to do you will improve your diabetes because the number one thing that helps it is weight loss, the bypass will help you lose the weight faster but you should get there with the sleeve.

[ProudGrammy 8,322]

When I told my dr. i definitely wanted the sleeve, he also tried to change my mind and have the gastric bypass. I don't whats going on with that. I just don't want that big surgery either, i also don't want my intestines messes with. Also the sleeve is the only WLS that has no absorption problems. This is extremely important due to the the fact I have epilepsy

I do have diabetes, i was under the hopeful impress that having the sleeve would eliminate diabetes. It does this with gastric bypass - but my surgeon says it doesn't always clear diabetes. oh well we'll see. I would love it the WLS would clear up my diabetes, or at least lessen it.

[Shellyac 22]

When I told my dr. i definitely wanted the sleeve, he also tried to change my mind and have the gastric bypass. I don't whats going on with that. I just don't want that big surgery either, i also don't want my intestines messes with. Also the sleeve is the only WLS that has no absorption problems. This is extremely important due to the the fact I have epilepsy

I do have diabetes, i was under the hopeful impress that having the sleeve would eliminate diabetes. It does this with gastric bypass - but my surgeon says it doesn't always clear diabetes. oh well we'll see. I would love it the WLS would clear up my diabetes, or at least lessen it.

I think that the reason that doctors prefer the bypass for patients with diabetes is that the improvement is seen much sooner. My diabetes control isn't the best which is the primary reason my doctor didn't want me to have the band, because when compared to bypass weight loss with the band is slower and I believe that both the rapid weight loss and the malabsorbiton are what helps improve the diabetes. The sleeve wasn't an option for me so I'm deciding to go with the band with plication. Since this is a new procedure I'm not sure how long it will take to improve my diabetes but initial results show that weight loss so be similar to the sleeve so I'm hoping my diabetes will be resolved or improved by a year out.

Make sure that you are also working closely with your endocrinologist (if you have one), they may have you change your medication immediately after surgery, mine is having me cut down to one medication and the amount I take will depend on my sugars in the morning

[ProudGrammy 8,322]

hi shellyac - thanx for your thoughts on the diabetes situation. I do know that the gastric bypass et all does improve diabetes quickly - i hope the sleeve does improve my situation.

what is the band with plication?

good luck w/your journey kathy

[Shellyac 22]

The band with plication is similar to the lap band but in addition to implanting the band you stomach is folded in on itself to form a sleeve and the folded stomach is sutured. The results in that you not have a stomach similar to the sleeve but your stomach is intact. Because the stomach isn't removed it is considered safer and reversible (and by reversible I mean that the procedure can be undone...ie the sutures removed, the stomach unfolded, the band taken out...but there may or may not be physical changes to your stomach after the removal). This procedure is still investigational, the plication can be done alone but as of now i haven't seen it covered by insurance, for me and others the band with plication has been covered by insurance. Another advantage of this procedure is that, like the sleeve, you are not making any changes to the digestive system. Also it appears that the plication helps to prevent some of the common complications of the band, such as slippage and erosion. In addition you don't need to go for fills as often and some people never get the band filled at all. Finally unlike the band alone, plication should make it harder to cheat the band because instead of the foods that can easily slip past the band going into a normal sized stomach it will go into one that is greatly reduced.

Again, this procedure is new and there aren't that many US doctors that are preforming it. There haven't been very many studies conducted on it but it does show promise and if the early results hold up,it will provide similar weight loss results as the sleeve.

[Roy 0]

I was diagnosed with type 2 diabetes over ten years ago and as my weight increased so did my meds. My primary care physician has maintained for years that if I would lose the weight the diabetes would go away as well. Unfortunately my insurance carrier and policy excluded any form of weight loss surgery regardless of reason. A few months ago during a regular doctors visit I was told my weight had become terminal and that the surgery was my best option to extend my life.He suggested I could pay for the surgery myself and enjoy a long life or not and let my family inherit my savings in two or three years.

I began a research on the three basic options right away. Lap-band, although the lest intrusive, tethered me to a doctor for the rest of my life and was much more restrictive as to my future food choices. The sleeve, also minimally intrusive, had a fast recovery time, was the least restrictive in future food choices and did not require the removal of major body parts and finally the by-pass. The by-pass was explained by my surgeon as a final stage type of procedure. Something to perform when the first two options either could not or would not be suitable. I chose the sleeve.

Prior to starting my pre-op liquid diet I was on 11 different medications for diabetes or high blood pressure. Seven days post-op I am now on 6 meds and it is expected that I will be off all meds by this summer. The real lesson here was that my diet first and then weight were responsible for my blood sugar levels. Now that I'm watching what and when I eat things are coming in line like never before. I am confident the choice of the sleeve was right for me and my diabetes. The by-pass would have been overkill. Choose an experienced surgeon and best wishes on your adventure.