Insulin Worries after DS

[LAU1310 0]

I have DS surgery scheduled for this Friday (4 days) and initially I was super excited. My main reason for doing this (besides weight loss) is to hopefully be off all diabetes meds including 2 types of insulin and 6 shots a day. My surgeon has said that he will discharge me from the hospital off all insulin, which I was ecstatic about. However during my pre-op visit with my PCP I was told that will definitely not be the case and if I follow that advice I will go into DKA and end up back in hospital. She went on to say I may never be off insulin despite the surgery and was generally kind but discouraging. I am now second guessing my decision to have surgery at all. Does anyone have any experience with this? Should I listen to the surgeon or my PCP?

[RickM 1,747]

From what I have seen, you may or may not be off of insulin and meds immediately - I think your surgeon is just being optimistic and won't actually discharge you without verifying your status.

My wife was diabetic, just short of being insulin dependent and under treatment for it for around twenty years, and it took her the better part of a year to be fully off all of diabetic meds. The surgeon explained that generally, the longer one has been under treatment, the longer it takes to get off of the meds, though there are some long term diabetics who leave the hospital free of all meds, even with just a sleeve or RNY rather than the stronger DS. Her diabetes is still in remission 15-16 years later, despite some subsequent regain and losses.

A few years ago, we talked to a woman in our support group who had an RNY some twenty years prior, and now her diabetes was coming out of remission with only some moderate regain, so she was in line to get that revised into a DS to knock it out for good.

So, it is still very much worth getting the surgery even if you don't immediately go into remission.

Note that I am referring to the "traditional" BPD/DS, which is known to have a 98-99% success rate with T2 diabetes, rather than the simplified SIPS/SADI/"Loop DS", which is not as well established.

[Lisa LoVuolo 63]

Listen to the surgeon

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[lizonaplane 1,612]

Your PCP may or may not have much experience with weight loss surgery. What about your endocrinologist? I doubt very much that they would not check your blood sugar before sending you home without your insulin and other meds, as @RickM said. But talk to your surgery center about what your PCP said and your concerns, but don't cancel your surgery. Even if you can't immediately go off your meds, there are lots of other health benefits to surgery and you might in time be able to go off the meds. The goal in life isn't to have the fewest pills; it's to live the best life, with or without pills. I take about 18 pills a day, none of which I will be able to stop after surgery because they are for a condition that is not caused by my weight. (The meds cause weight gain, but that's another issue.) I am still having surgery, because it affects my quality of life to be so heavy, and is going to lead to other health problems down the road.

[Lisa LoVuolo 63]

I had the gastric bypass March 15 2017 I still have insulin as needed

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[Greendragonfly 110]

My endo stopped my insulin 3 weeks before surgery because I was only having Protein Shakes and one meal consisting of Protein and vegetable. My food intake was not enough to cause high blood sugar. I remained on my metformin until 2 days before surgery. Since surgery I was told as long as my sugar remain under 170 I do not need to go back on metformin. Im still on the full liquid diet and perhaps as I add food back I will need medication but Im hoping thats not the case. 🤞🏻🤞🏻Prior to surgery during the pre op diet I did have one sugar drop and was able to eat some crackers to bring my sugar back up. No crackers allowed now so I would be afraid of a sugar drop.