Type 1 Diabetes and the Sleeve
I have not yet had the surgery, but am about 3 weeks out. I am a life long Type 1 diabetic and I too wear an insulin pump. I know you're looking for people who've already had the surgery but I didn't see any responses so far and thought I'd post a reply. I've been in close contact with my Endo on this topic, as I've been worried about the same thing. He basically said I should put the pump back on after the surgery and let the pump continue with my basal rates. Basal rate needs should remain the same for the first few days. It's the boluses that will likely need to be modified. My doc says as the weight starts to drop off, the basal rates will likely decrease. He also said an increase in blood sugars could happen due to the stress of surgery. I know this wasn't what you were looking for but I hope it helps a little. My surgery is June 6. I'd be happy to report on what my blood sugars do. Good luck.
Thank you so much for taking the time to write. She just got back from college and we will be seeing Endo next week, but he is new to her. She has been diabetic since the age of 13 months, so we've been doing this a long time, which is why this surgery is so important. She is type 2/insulin resistant, also, so has a double whammy. We see the surgeon on Thursday so I'll see what his take is. I wish you the best of luck on your surgery! and thanks again!!
Your day is fast approaching. Please let me know how you are doing. Endo wants an Iv insulin drip, but surgeon does not want that. Requires Icu for insulin drip. we are having to pay cash for surgery and icu not part of the plan. Are you putting your pump on immediately post op for the basals? Let me know as that is an option for us instead of an iv drip. I am staying with my daughter, and am a RN with lots of experience in DM....still not sure how it will all play out. We have the sensor for her and may plug it in post op. My husband is an internist and will be staying with us overnight in the hospital, but he will not be doing her care, just standing by in case. I'm the usual diabetes person.
Hi, Sorry it's taken me so long to respond back. My endo wants me to put my pump back on as soon as I wake up from surgery. I'd be worried about an insulin drip too. From what I've read most type ones don't need to bolus at all right after surgery because for those first few days it's only clear liquids and not much of that anyway. I guess I can see a drip if her blood sugars were going too high, but if not, i don't really understand the need either. The only other surgery I had that wasn't outpatient was a C-section in 2010. I had the same endo at that time and we did the same thing. Pump back on right after surgery and I checked my own sugars and reported them to the nurse. I'm also a bit of a control freak about my DM management though :) and I don't really feel the need to be poked however many times, when I can just put on my pump :) I'm just a week away at this point and getting very nervous. I plan to bring my laptop to the hospital, I'll keep you posted as much as I am up to.
Your reply's have meant the world to me. My stress level is thru the roof, but trying not to show it to my daughter..lol I wish you the very best luck on your surgery. I will be thinking of you that day. We are the 10th. My daughter's name is Elena and she will be posting once she gets her info on. We are pretty set, now. Surgeon and I are on board for putting the pump back on and letting her, I or my husband do the numbers. Her full liquids start Sunday, so just went to the store to stock up. I'm going on the liquids with her the whole way thru. We are very close. I'm a lapbander from 2007 and still doing fine. Again...good luck and smooth sailing!
I feel bad that you haven't gotten more answers as of yet. Unfortunately I was or am Type II and that is a different ball of wax so to speak. I never was on insulin however I can report that I was on two medications Metformin ER 500 mg (2 per day) and Glimepiride once a day pre op. Since one week pre op I stopped all meds and haven't had any for one year this month. They say there is never really a cure but instead a remission for Type II anyway.
I don't know the answers for what happens with Type I. Is there any way that you could ask the surgeon? If not I am still on great terms with my surgeon and he encourages us to send him emails with questions. If you want I would be more than happy to send him an email with your question and see if I can't get back to you with an answer within a day or two depending on how busy my surgeon is. Usually he doesn't do surgeries on Wednesdays so I might get something as soon as tomorrow.
As I was typing that out I think I have already decided to send him that email and get an answer for you. That way I will know as well. I will post his answer as soon as I get it ... he hasn't ever really gone more than four hours in answering so I expect something for you tomorrow.
im type 2 but type 1's don't produce insulin so you will always need to take some , but you will be eating much less carbs so you will need much smaller doses , if you have a good endocrinologist , they should have no problems adjusting the dose
I am a T1 Diabetic on a pump also. Because I was doing such a low carb diet right after surgery, only needed my basal delivery. Occasionally would need to bolus for crackers or juice. Now that I am a year out, I am eating more carbs and have to bolus for those. Because of the decrease in food volume, obviously, the daily amount of insulin I need has lowered. It will take some trial and error.
One thing you need to be sure is to have juice for the lows. Since we can't eat a lot - or very fast - I have found that sometimes treating a hypo is difficult, but juice makes it easier.
Good luck to her!! Feel free to message me if you have any questions.
Did you put your pump on post op for basal coverage right after surgery. How did they give you insulin. Just chem strips and coverage or did you have a long acting insulin or use your basal via pump. Endo talked about Iv insulin but they only do that in icu and that is not covered on our cash pay plan. Wondered if any type 1's put pumps/basals and sensors on immediately post op. Sent you a message too, so disregard that.
I finally did receive a reply from my surgeon although it really wasn't too much information.
He wrote the following ..
"I think it would help her out significantly, though Type I may not completely go away as often as Type II.
We can manage her sugars. I wouldn't worry too much. We've had others in this situation before.
Let me know if she has any more questions."
I think that by help her out he meant the VSG. As for managing her sugars I am sure he was basically saying since they are aware of the changes in diets as well as her situation that it is easily managed and that she obviously isn't going to be the first patient that they have had with Type I Diabetes.
Either way I am afraid I wasn't too much help although I see you did get another post that was much more informative. Sorry that I couldn't give you better information.
It bothers me that your dr would say "I think it would help her out significantly, though Type I may not completely go away as often as Type II." Nothing will cure T1 - not this surgery, nothing. Scary that he doesn't understand how T1 works. WLS helps and sometimes cures T2, but T1 is an autoimmune disease. Changes in diet and/or weight loss will not fix T1. It will not go away. Just know that.
Be your own advocate. Insist that you have control over your pump/blood sugar. You know better than they do about your D management.
My thoughts exactly. I understand that people don't always understand Type 1 diabetes, it's a complex disease. BUT it really worries me that a surgeon would say that. Nothing against the person who posted it.....at all. But the surgeon is incorrect. Trust us type 1's- we'd know if there were a cure :)