Has Anyone's Diabetes Returned?

I will be undergoing VSG surgery Feb. 26, partly for weight loss but also in an attempt to "cure" my Type 2 diabetes. Assuming that my diabetes does actually subside, I've heard that this may only be a temporary fix and that diabetes (rarely/sometimes/often?) returns. I just wanted to hear from VSGers who lost their diabetes after surgery. Did it subsequently return? If so, how long after surger? If not, how long have you been diabetes-free?

Tom, very relevant questions! But the answers will depend on the different baseline data that everyone has. Such as...how long have you been diabetic? Are you on oral meds or insulin or both? Have you had a test done of your beta cells and how many % terms are still functioning? Is your type 2 weight related even or not? I have seen a few folks on the diabetes board say theirs came back after some years post RnY. One can never be cured of diabetes. You can be in a longterm remission however. The DS is the surgery that provides the best results in terms of diabetes remission long term. For me, having been diabetic for probably three years or so before surgery, on metformin only, my blood glucose levels have been normal since day three post op. No meds. Hope it stays this way!! But no way to tell for how long...keeping to a low carb diet works to keep bg numbers stable.

It seems that the biggest factor in keeping diabetes in remission is keeping the weight under control long term. As Wantmylife noted the many factors involved, not least of which is whether or not your case is all that weight related.

At our support group a few months ago, I was talking with a woman who was 25 years out on an RNY who had successfully maintained everything for over twenty years until some life stresses popped up that brought back some of her weight (not the 100+% regain we hear of sometimes, but maybe 50-60%) and along with it came her diabetes out of remission. She was in the process of getting a revision to a DS to knock it out again. The DS typically sees about 98% success in treating diabetes compared to around 85% for the RNY and VSG, so that is a factor along with the varying characteristics of the different procedures to consider.

Thanks, both of you, for the info.  The nature of my problem is insulin resistance which steadily increased with my weight and age (I'm 53) over the past 8 years or so, progressing to the point where I require fairly hefty doses of insulin as well as metformin.  My BMI is just under 40.  I realize that if your pancreas is just not producing sufficient insulin then there's not too much you can do but my understanding is that VSG surgery (as well as the other types of WLS) can break that insulin resistance (the underlying mechanism is not yet understood).  It is the actual surgery itself that seems to do this, not the weight loss since blood glucose levels are normalized just days after surgery.  Normalization through pure weight loss seems to be a different mechanism, one that could be obtained through means other than surgery, and I can understand why regaining weight would cause one's diabetes to return in those cases.

At any rate, I hope to lose the weight and keep it off so your story of 25 years of successful diabetes remission has me hopeful. 

It seems to be a combination of the two, with the surgery being a major, but variable, component. When my wife was going thru this (she had a DS about eight years ago,) the prevalent thought in the business was that the intestinal rerouting of the DS and RNY was responsible for the success in treating diabetes, while it was basically the weight loss that was responsible with the bands. As the VSG became more common as a standalone procedure, experience has shown that it, too, is often showing quick diabetes resolution, long before weightloss becomes a significant factor; so there certainly is some hormonal and/or metabolic influences from the gastrectomy itself. The DS started as a surgical treatment for diabetes, to which the sleeve was added to make it a WLS, so that probably explains its' better track record over the RNY.

The normalization of blood glucose levels is a variability (again, lots of variables, not all of which are fully understood) but there is a correlation between the length of time one has been under treatment for diabetes (implying severity or progression of the disease,) and how long after surgery it finally resolves. My wife, who had been under treatment for about twenty years and was at the limits of drug therapy of the day, just short of needing insulin, took close to a year after surgery to resolve (she was a mid 60's BMI and took around 18 months to lose her 200+ lb.) But then there are always those outliers who have been under insulin therapy long term *****solve in the hospital after their VSG. Go figure.

Good luck with your journey - maintenance is the key, and you have a great shot at it here (and on the maintenance board, when it comes to that time.

You are absolutely right Tom. The surgery does have a metabolic component as there is the removal of the part of the stomach that produces ghrelin. There is also an influence on a couple of other gut hormones that also trigger insulin responses. So yes, the remission days after surgery indicates that it is not just weight loss that leads to remission but something else linked to the surgery itself. I too will take a 25 year remission window with pleasure!!! That should be enough for me!

I just had VSG on Feb. 5. Unfortunately, I am one of those folks that did not get immediate resolution. I am 3 weeks out and my doctor put me back on short acting insulin 3 times a day- although at VERY low doses. My doctor mentioned that there is a genetic component to diabetes as well as the weight and length of time as a diabetic. I have been diabetic for about 8 years and my grandmother was and older sister is type 2. He also told me resolution has to do with how "tired" my pancreas is. I, like you, am hoping for complete resolution after my 100 lbs weight loss. I was on 2 oral meds and both long and short acting insulin that required 5 shots a day of hefty doses of insulin. Keep us posted of your diabetes resolution and good luck with your VSG surgery!

Thanks for the reply, Plaid, and your best wishes.  Your history mirrors mine to the letter, except that it is my brother that has diabetes rather than my sister (and my Grandmother) so I also have that genetic component.  And I guess after 8 years both our pancreases might be too tired for complete resolution.  I too am on orals and hefty doses of short/long acting insulin which is what prompted me to go for WLS - I was tired of the spiraling use of meds with corresponding weight gain so time to do something to break the cycle.  Well at least we will be healthier over-all and there is still a chance that 100 lbs of weight loss could result in a better resolution for both of us.

I'll post my results in a week or two.  Good luck with the rest of your journey!