ObesityHelp

I'm very sorry to hear this and I know you feel stuck in a loop that you can't get out of right now!  It's awful when you don't feel well and then feel so out of control. 

The first priority, in my opinion, is to try and get better control of your blood sugars.  Most surgeons won't do surgery on you, I would thin****il that is better under control.  Do you have an endocrinologist that you work with on a regular basis or is most of your care coming from the ER when in crisis?  If it's the ER, you are only going to get emergency, not long-term, care.  And that is going to keep you stuck in this cycle you are in.

You need a good endocrinologist to start working on this issue with you right away, and you need to commit yourself to working at this in a very focused and deliberate way.  It's probably going to take a while to bring everything down and under control and you might need to try a number of different medicines and methodologies (perhaps the pump) to get you there.  You will likely remain frustrated for a while, but your efforts will pay off if you and your doctor can work together.  Small steps matter and can lead to big things, but you need to sustain the effort, be honest with yourself and your doctor, and listen to direction and feedback from your healthcare team.

Yes, your weight will continue to go up with lots of insulin.  Believe me, I know that cycle well myself.  But, right now, you need to improve your control first.  Once that happens, then you can begin thinking about WLS surgery.  Perhaps you need to consider something more than the band?  I think it's probably too early to even go there.

Please find an endocrinologist.  And keep us posted. 

Get WLS. DS would have better long term control, but even RNY would immediately improve your levels.
Another band would slip too, since the last 2 did. Don't be afraid, jump in there and make a decision to live longer and healthier.
As for your levels now, I always cut out all carbs except in a low carb salad dressing and eat salads twice a day, and for breakfast eggbeaters with cheese. After about the third day, my fasting glucose level would be below 150, sometimes as low as 110. Then I would   add low carb vaggies back in with any meat, chicken or fish. All carbs are the devil for diabetics.
My A1c was around 11 before weight loss surgery. I did the salad and eggbeater thing to get below 10 for surgery.
Best wishes.
ETA: before surgery I took 90 units of Lantus once a day, 45 reg for  breakfast, 35 for lunch and 45 for dinner. Didn't help much without letting go of the carbs.

Jen: Do you know what diabetes type you have?  About 10% of those diagnosed with Type 2 are NOT Type 2 - they are what the literature and docs call Type 1.5 (or LADAs - latent autoimmune diabetes in adults).  The age of onset is usually around 30 and there are blood tests you can have to determine whether this is you or not.

The reason I mention this is that WLS surgery can greatly improve your overall control, but you will still function like a Type 1 diabetic and likely need insulin, albeit in smaller doses with better results.

I was diagnosed at 29 and have had diabetes for 25 years now.  I just had RNY in September and found out just about a year ago that I had LADA, not type 2.  I have gone off a lot of my oral meds and reduced my insulin.  But, I still need it.  My endocrinologists always thought that I didn't quite "fit" the Type 2 diagnosis, and frankly, I never really did.  I initially hoped that WLS would take this all away, but once I learned that I truly was a Type 1.5, I had to readjust my expectations for outcomes.  I'm glad I knew it before the surgery.

Totally agree with your statements that WLS is the only way to go for any type of metabolic intervention that can impact diabetes.  I never even considered Band surgery - it does nothing to change the way the body metabolizes food/calories.  

Best of luck to you!
 

Hey Jen:
I didn't mean to cause you to question your type.  It's just that there is so little out there about the type 1.5's (LADAs), especially regarding the connection with WLS.  When I found out that for certain that I had type 1.5, it stopped me for a few months and made me realign my expectations for the surgery. 

I did the surgery for one reason - to improve my health and diabetes control.  The weight loss is an added benefit that it more visible to me and to others.  But the numbers that matter most to me are the ones on my glucose monitor! 

Good luck - sounds like your surgery is coming up soon.  You will feel SO relieved when you are on the other side of it. 
Best to you!

 My PCP was just telling me about intestinal sleeves.  While they are still in the early research stages, the results have been very good:  resolution of DM2, weight loss not quite on par with bypass, but better than the band.  Oh, and it's non-surgical, done endoscopically.     Not sure where you are located, but were I you I would not only speak with an endocrinologist, but seek out a bariatric program at a teaching/research hospital.  They would probably be best to inform you of procedures or trials that could be helpful considering the inability to control your diabetes with meds and other comorbidities.


http://articles.latimes.com/2011/apr/05/news/la-heb-diabetes-bariatric-sleeve-20110401

"...In the meantime, Kaplan suggested a one-year respite from diabetes could be valuable for obese diabetic patients who need to improve their metabolic function before they can undergo needed surgery or radiation therapy."

also see
http://www.weightlosstriumph.com/endoluminal-sleeve-non-inva sive-alternative-to-gastric-bypass-to-treat-obesity-and-diab etes.html

I would ask for DS weight loss surgery. And fight to get it.
When I was on 2 types of insulin and couldn't get the sugar level down, I would cut all carbs for 2-3 days, and eat salads with SF dressings, and proteins like fish, chicken or beef. No fruit, milk, bread, rice, cereal, grits, potatoes of any kind, corn, dry peas or beans.
This usually would allow me to wake up with a lower fasting glucose level, and easier to maintain throughout the day.Shooting for anything below 200 would be a good first target.
Then add veggies back in slowly ( other than salad greens etc). This isn't a long term solution, but a quick way to lower the too high sugars.
MY A1c was above 11 before surgery, and I used this plan to get it a little lower for surgery.
Best wishes!

 You can add me to the list of diabetics that was not in control of my sugar level.  The preop diet helped tremendously and now 5 months out, I still have to take some insulin but not nearly what it used to be.  Metformin gave me  uncontrollable diahrea so that is out of the question.  Right now my fasting sugar is 130 to 150ish.  

I agree with the other comments:  you need an endocrinoligist and I do too.  They are so booked up and so few and far between.  You will feel so much better when you get everything under control.