Diabetes Resolution - WHAT WAS YOUR OUTCOME WITH GASTRIC SLEEVE?

[kefi 0]

Hi Eveyone

Have surgery date for February. I am BMI 40. Suffer from sleep apnea, diabetes, hypertension (not that bad really) and fatty liver. My reason for the surgery is to resolve health issues, especially the diabetes.

My bariatric says gastric bypass and gastroenterologist also agrees, but I am struggling with that choice and instead am leaning towards gastric sleeve.

My question is: for those who have had gastric sleeve, what was your experience with your diabetes afterwards. Did it resolve? Immediately or when you lost weight? Or minimal impact.

I can live with controlled diabetes but want to halt the progress as much as possible. Currently I'm on oral meds only plus one subcutaneuous injection that is keeping A1C in 6.6 range. Not taking insulin. Diagnosed 7 years ago

What is your experience after gastric sleeve if you are diabetic???

Thanks!!!

[kefi 0]

ps - yes I understand the difference between GS and GB and the fact that bypass is the gold standard, especially when it comes to diabetes resolution.

[dlappjr 467]

I was 380lbs, 56+BMI, Diabetic, Hypertension and sleep Apnea before I had the sleeve. I took Metformin, Glipizide and Januvia to try to control the Diabetes. My sugars were still always high. 120-130 fasting and 160-180 after meals. My lowest A1C pre-op was when I was diagnosed as Diabetic, at 6.8. The day before my sleeve surgery I had my last Diabetes meds. When I left the hospital, I had a follow up within a week with my primary dr. I did not take my Diabetes meds as the pills were pretty large and I didn't want to risk damage to my new smaller stomach. I told him about not taking the meds and he told me to monitor my sugars closely. As long as they were within range 80-90 fasting and no higher than 120 after meals, I could stop taking the meds. I have never taken another Diabetes pill since surgery. I am also almost no longer diabetic. At my last 90 day follow up, my A1C was 6.2, after being at 8.2 a month before surgery. He also cut my Lisinopril for High Blood Pressure in half and my Cholesterol med in half. Hoping next month at my next 90 day follow up that I can maybe lose one or both the Hypertension and Cholesterol meds. The sleeve has been a huge success for me. That said, the bypass is not a bad way to go either. I didn't want to deal with lower absorption you get from the full bypass and knew I would have to work a little harder to lose more weight than with just the sleeve and eating better so I was willing to workout harder for the loss. So far so good. Best of luck on your decision. I am still hoping one day to kick the clap to the curb, but for now, I still need it.

[kefi 0]

dlappjr,

Thanks for the feedback. Just curious, you probably got the same advice to do the bypass, so why did you decide on the sleeve instead? Does your surgeon consider your case typical for sleeve and diabetes resolution? There doesn't seem to be much statistics out there. Although, hearing your case is very inspiring. I do notice though that you are 4 months out of surgery so do you feel perhaps the effect is because of the sever caloric restriction that you are experiencing - or does your doctor feel this will continue? What I've read so far is that the diabetic resolution is instant with bypass but typically for sleeve it happens as the weight comes off and/or the patient's food intake is severely restricted. Your case though kind of sounds like the instant resolution that bypass patients experience.

Wishing you lots of continued success!!

[dlappjr 467]

when my primary care dr. recommended me to the Weight Loss center, he didn't specifically say what procedure he would recommend. Before I met with the surgeon, I attended a seminar at the hospital to learn more about both. I made the decision for sleeve based on the fact that I did not want to mess with having to bypass some of my intestines. For some reason, I felt that I wanted to leave everything else alone, and just aim for getting the smaller stomach. Another thing was that because with the sleeve, they remove the extra part of the stomach, you lose the creation of all or most of the Grehlin, which makes you feel hungry. I liked that option as well. When I finally did meet with the surgeon he said that the sleeve was a good fit for me and that he recommends the sleeve to most patients due to it being less intensive and a better fit for most people. for me, getting rid of the Diabetes was the primary reason I looked into this to begin with. That said, at no point did I feel like I should do bypass because of its ability to relieve the Diabetes or would cause me to lose more weight than the sleeve. I just never felt that the bypass was a good option for me.

Edit*- Oh and as for my thoughts on losing the diabetes so quickly with the sleeve. I think the pre-op and immediate post-op diet is so restrictive that it kept my sugar levels low. I was concerned that after I was able to eat more normal foods, I would see an increase in my sugar levels, but I did not. I also never got any of the symptoms of high blood sugar, like vision issues or feeling tired and lethargic. This might not be typical of everyone. Another thing to keep in mind is how much you have to lose. If you are more comfortable with the sleeve, do that first, because it can always be converted into bypass if after a year or so you feel you need a bigger tool to help you.

Edited December 11, 2015 by dlappjr

[dlappjr 467]

and talk about all of this with your dr. and surgeon

[animallover1247 249]

Hi Kefi

I will not have surgery until next month BUT I will tell you my experience with the surgeon.

I am diabetic as well, I am on fast and slow acting insulin and Truclity. I was placed on Truclicity because I had gained 24 lbs in three months being on Lyrica. Trulicity has the side effect of decreased appetite. I have made changes before surgery that resulted in no need for cholesterol meds and a decrease in both of my insulins. My last A1C was 5.9, the lowest it has ever been but usually ranged between 6.2 and 7.5. I have been diabetic for about 12 years and on insulin for about 7.

When I went to see my surgeon, he told me the gold standard for diabetes is the bypass. I told him I was aware of that but I did not want bypass for many reasons, one being the rerouting of the intestines and the surgeon said the hair loss is worse with bypass as well.

Having said that, my surgeon stated he did not have a problem at all doing the sleeve on me, thankfully, because I don't know what I would have done if he would have refused to, I don't think I would have agreed to the bypass but who knows what I would have chosen to do if my back was against the wall.

I have done a lot of research on the sleeve and diabetes. There are many people who have been able to go off of their medications after surgery, many of them leave the hospital not taking any and if not they eventually get off them or significantly reduce them. I have seen a few people who post they are still on the meds but I think it depends on how long you've been diabetic, how well it has been controlled and if you were on insulin.

i think I will be able to go off of my meds, if not immediately, with significant weight loss.

It's a personal choice but I don't think there's any problem getting the sleeve if you have diabetes.

[Waler 330]

Before I was sleeved I also was a diabetic, with high blood pressure and sleep apnea. Post op I no longer take any meds other than my Vitamins and supplements, the sleep apnea is gone as well, which made my wife even happier than me.

[kefi 0]

Waler, were results immediate? Can u share ur weight profile or pm me. What did ur surgeon recommend? Thanks

[MrsSugarbabe 727]

Before my sleeve surgery, my A1C was 5.8, managed my BS with Metformin 3xday, exercise and food choices. I also had HBP, fatty liver, sleep apnea/hypopnea (the hypopnea being the bigger problem for me). Weight loss goal was to lose 100 lbs. after surgery. My PCP and surgeon both strongly recommended bypass, but after much consideration, research and conversation with others I know who have had WLS, I decided that the sleeve made the most sense to me for me. I have been very pleased with my decision. Pre-surgery I had to stop several medications in preparation for the surgery. After surgery I never went back on the Metformin or BP medication. Besides supplements, the only medication added after 9 mos. post-surgery has been for triglycerides. Even with the weight loss, much increased physical activity, and changes in food choices, etc., my triglycerides remained just barely above the recommended maximum. Medication has improved that considerably. One year post-surgery my A1C is 5.2, BP is in a more normal range and I did not restart BP meds post-surgery; and after meeting with a liver specialist, he told me he felt the fatty liver issue would resolve with continued weight loss. The liver biopsy showed no cirrhosis and other markers he looked at did not cause him concern. Having the sleeve did help me be more successful with all the lifestyle changes needed to lose weight and keep it off because my new tummy just doesn't hold much food - about 2/3 of a cup; anything more than that and I can become pretty miserable very quickly. However, it still takes a lot of work to lose weight and to avoid letting old bad habits creep back in. I have been on a plateau for about 5 months now and am still about 40 lbs. from goal. I am not discouraged or frustrated at this point. I just keep doing what I know I'm supposed to be doing although I do make the occasional poor choice in either food or quantity. I'm very glad I had the surgery. There's nothing magic about it; you still have to do the work; it is an excellent tool for making some great weight loss progress quickly.

One thing I did before I actually committed to having the surgery was to replace my Breakfast and lunch with an powders?utm_source=BariatricPal&utm_medium=Affiliate&utm_campaign=CommentLink" target="_ad" data-id="1" >unjury Protein powder shake or the Unjury chicken Soup powder. After doing that for about 2 weeks I noticed that I did not crave carbs like I did prior to starting with the Unjury. It's a great product and I recommend it highly!! I ordered it online directly from Unjury so I could get free shipping. Because the sleeve is restrictive in nature, the only way I can get the recommended grams of Protein each day (100) is to have at least one serving of Unjury either as a Meal Replacement or snack. You may want to give it a try. Unjury also has a dietitian available to talk to any time. (No I don't get paid to endorse their product I just think it's that good.)

Good luck on your journey!!!

[Tbeek 21]

I had diabetes and high BB. Right after my surgery I do not take either and I am 4 weeks post op and holding. A lot of hi blood-pressure issues is due to diabetes. If your high blood pressure has more to do with genetics you may still need to be on some high blood pressure medication. But your doctor will sort that out as you lose weight after surgery.

[healthyamy 6]

My husband and I are getting the sleeve. My husband is a diabetic and he takes fast acting 10 units 3x and slow acting insulin at bed time and also metformin 1000mgs 2x daily. He weighs 277 and is 26 years old. Has anyone had to take meds like this before surgery and if so are you still on any med after surgery