help me calm my nerves

[nsweety123 19]

My surgery was supposed to be on October 24th but was postponed due to my a1c levels being 12 in July. Yes they waited until september to tell me now i have write everything down because November 1st my doctor will tell me if its ok. my concern is what then what do i do the a1c again or does my doctor just give the ok?

[unbesleevable1 420]

Punctuation would help a lot. I'm not sure what you are trying to say.

[nsweety123 19]

First of all I am writing via my phone any intelectual can read and understand my question without being cheeky.

[nsweety123 19]

My surgery was supposed to be on October 24th but was postponed due to my a1c levels being 12 in July. Yes they waited until September to tell me,now I have write everything i eat and keep a journal of blood sugar readings because on November 1st my doctor will tell me if its ok yo have my surgery. My only concern is what then? What do i do? The a1c again or does my doctor just give the ok?

[Mrs. Hoffman 1]

How can u lower your ac1?? Mine was at 12 as we'll.?

[nsweety123 19]

My doctor actual put me on this new med calles invocanna which i take in the morning with my insulin and it actually works. My numbers in the morning are horrible but since on it helps. Look it up also she changed my units to higher at night. Hopefully she clears me on the 1st.

[Mrs. Hoffman 1]

I haven't gone yet to see my sleeve doctor my appointment is tomorrow. But I've been reading on here that they won't do the surgery if a1c his higher then 8.0. And when I called my doctor to find out it's was at 11. So now I'm anxious to see what the sleeve doctor says I'm praying it go's throw still. And thank u I'll ask my doctor about putting me on that.

[Peggy D 124]

Ask your surgeon if he/she has a requirement for your Hgb A1c.

I always have had a problem with high fasting blood sugars. Even back to when I only had gestational diabetes with both of my pregnancies that resolved after delivery. No matter how I adjusted my evening insulin that I took before dinner, it would be 170-180 or so in the morning, yet I would often have dramatic lows during the night.

I started a low carb, high Protein diet (like Adkins or South Beach) the day I saw my surgeon for my first consult. My sugars were a bit better, but not by much, & probably more because I lost about 20 pounds in the first 6 weeks on that diet.

Two months later I was so frustrated I went online & did a lot of research about the onset & peak timings of regular & NPH insulins. I had learned that in nursing school, but that was so many years ago & I didn't work with adults with diabetes to keep my knowledge fresh. I've never liked "micro-managing" my insulin but I had to do something. Because I am a nurse my PCP has always allowed me to manage my insulin with certain guidelines & I did check with his office about the changes I made. I started with checking my blood sugar 4-5 times a day & taking my NPH insulin 3 times a day, rather than twice - in the morning before Breakfast, at bedtime & halfway in between in the mid-afternoon - dividing the day total into 3. Then took regular insulin before each meal & snack. I was able to reduce the total insulin dramatically within a few days as my sugars were so much better. I used to take 20 units of regular before Breakfast & before dinner & 35 of NPH before breakfast & 40 of NPH before dinner. Two months later, just before surgery, I was down to 20 units of NPH morning & mid-afternoon & 10 units before bed. I was taking 5-10 units of regular before eating, depending on my blood sugars. In the hospital my Hgb A1c was down to 5.9 from 7.3 that it was 3 months earlier.

[nsweety123 19]

Omg I took another test not the a1c but a fasting and my doctor said it was too low what the heck looks like no surgery until my a1c is checked. My head is spinning from the ups and downs.

[ShanRN 58]

I don't understand the logic behind a1c requirements. Most diabetics seek surgery because conventional methods haven't controlled their levels. Mine was hovering around 11 preop. It was never a factor in regards to being considered a surgical candidate. Is this an insurance or surgeon requirement?

For the record, mine has been in the 5-6 range since surgery I'll know officially when I get my labs drawn next month.

[SoccerMomma73 1,867]

Uncontrolled diabetes increases (significantly) your risk of complications during surgery and causes issues with healing so some (no all) docs require your A1C to be less than 8 or less than 9 (which is still not at a controlled level) to try to decrease the risk of these complications. I'm a bit baffled by them saying your sugar was too low though....low is what they were trying to achieve ??? Good luck! Hope they do that A1C soon!!!

[ShanRN 58]

I understand the healing issue but it still doesn't make sense. Extra diligence during the healing phase can eliminate most of the diabetic risk of complication. I'd say it's more of a risk to *not* do anything. I saw three surgeons and none of them mentioned an a1c requirement. But then again.....a lot of the rules don't make sense. The one that truly kills me are the policies that insist you lose certain percentage of weight before they'll pay for surgery. It's like....seriously??

Hope your blood sugar troubles resolve enough for surgery!

[SoccerMomma73 1,867]

I'm post-op 9 months so I'm out of all that mess . What gets my panties in a bunch, is the docs that require all kinds of extra stuff (such as the losing of x% of your weight) that insurance couldn't care less about. A lot of the insurance policies are very basic, surgery approved if patient has BMI >40 and has documentation of previous weight loss attempts. But some of the programs really add on what's required. Sucks for us. Personal pet peeve? Surgeons that make it sound like losing weight pre-op is just a piece of cake...if only