DOES ANYBODY KNOW THE BEST WLS FOR TYPE I?

Hey guys.  question.  I have a friend that has Type I Diabetes, and we are trying to figure the best wls for them?  Any suggestions, I know they will talk with doc' etc...but between us, and maybe people have experience in this?  thanks..

I attend 3 support meeting per month. My surgeon's nurse addressed this topic last night--discussing RNY, sleeve and band surgeries.  With RNY:  GERD is gone, no NSAID meds, type II diabetes is typically fully resolved, Type I may be completely gone, or patient is off insuline and/or possibly on some minor meds.  Basically diabetes is in remission. Gain a lot of wt post op, and diabetes may return.  History of other diabetic members of family tree may play into this.  If the friend needs to lose 100 pounds or more, RNY.  Sleeve: may help with diabetes, but may not fully resolve type II, lower wt loss then RNY, GERD is common, may be recommendations for full absorbtion of some script meds.  BAND: wt loss is a lot slower and lower, usually no help in diabetes, and tends to have more complications, and many have their bands revised to RNY or sleeve in the future.  RNY is usually considered the best for diabetics in trying to resolve diabetes issues. DAVE

Dave you saying that Type 1 may be completely gone or the patient is off insluin is soo wrong it makes me sick.  Type one is an auto immune diesease.  There is no getting off insulin for a type one.   With type 1 the body was attacked by itself and killed off the beta cells that produce insulin, all human begins need insulin to survive, remove your pancress and see how long you would live with no insulin at all.  I can promise you it wouldnt be long.  Type 2 diabetes can be resolved and put into remission with RNY or DS, but even that is not guarenteed.  Remember there is NO CURE FOR TYPE 1 DIABETES. 

To the op, as far as your friend wondering what would be the best surgery for them they really should talk to their endo and run the 4 types of surgery by them.   They should also talk to a surgeon who does all 4 surgeries and get their thoughts on what would work best for them considering their Type 1.

Wow, that seemed to be kind of a harsh response towards Dave's posting. Having read his posts to others over the last few years, I think he is generally well intentioned. I think that not everyone is aware of the differences between Type I and Type II Diabetes, and you did a great job explaining those differences. Some people might become confused between the use of Insulin and the kind of Diabetes they may have.

With that said, feel that your advice to the OP was spot on.  
Lisa

While type 1's will not be resolved by a wls, they can decrease the amount of insulin they take.

The RNY is good but the DS has better resolution results on diabetes. There is an article written that gave these rates: (Table 3)
Rates for remission of type 2 diabetes mellitus reported after bariatric surgery:
Procedure Remission                                                         rate (%)
Vertical banded gastroplasty                                               75-83
Laparoscopic adjustable silicone gastric banding         40-47
Roux-en-Y gastric bypass                                                    83-92
Biliopancreatic diversion                                                      95-100

I keep getting a server was reset going there but I did save it for myself: Link

There is also a known side effect called Reactive Hypoglycemia that primarily plagues RNY surgery. It does happen with the DS but usually with those of us who already have RH. See my blog posts here on OH, dated the 20th and 26th of May.

And I don't know how old your friend is but she also needs to consider that the DS/VSG both allow for NSAIDS (I do not know about the lapband but I would not suggest that to anyone myself...there are those who do well with it. But the statistics are against it)

None of the surgeries will get her off insulin...but the DS gives her the best chance of lowering the amount she needs.

I chose RNY for my Type I because I felt that it would suit my lifestyle. My Insulin needs have markedly decreased, though I had excellent control before surgery. I only cover for meals, with no long acting Insulin needed. My A1c stayed around 6.3%-6.5% before RNY, and now is 5.0%. I will never resolve Type I diabetes, but for me, it was the right choice. I think it all depends on what your friend's lifestyle choices are, how much weight she needs to lose, her age (I'm 52), and other factors. The best I can offer is to encourage intense research into ALL of the WLS options, though I would discourage Lap Band because of the risks related to diabetes ie: foreign material in the body, healing time, and higher risk for potential infection.
Lisa

Pre RNY I was on two different diabetes meds and my sugar levels weren't under control. Now i'm off all meds. Not saying this will work for everyone but its what i've been thru and what has happened to me.

Good luck

.

it was explained to me by several of the most re-known researchers at Cornell on diabetes and wls that wls does not cure it,  we think so because it cause us to change our intake and through put of carbohydrates so drastically that our management is so remarkable to effect a remission.    I had a ds a and a drop from 7.5 to 4.25 with out any dietary change. and I'm at goal one year later today.