Diabetes not resolved - insulin vs. oral meds

I had type 2 diabetes prior to surgery.  After surgery my A1C dropped from 8.2 to 5.  I was able to go off all my oral meds and just continue with a little bit of insulin taken just before bed to keep my morning fastings sugar levels where they needed to be.  I was elated! 

Then after some routine labs my doctor called to tell me my A1C was back up to 7.4  Now it seems like my sugar levels are all wacky again.  What happend?  How could it have been "fixed" by surgery only temporarily?

I had gotten into the habit of eating some bad carbs throughout the day, but since my labs came back high I have cut back and my sugar levels are still way too high.

So, my endocrinologist has started me back on oral meds.  I take a 1/2 of a 4 mg pill at breakfast and again at dinner.  So at each dosage I'm actually taking 2 mg then on top of my malabsorption, I must be getting very little. 

I voiced my concern to my doctor about whether this dosage would even do anything and he was confident it would.  Well, my sugar levels have budged with adding this medication.

I'm wondering if I wouldn't be better taking insulin since that bypasses my intestinal tract altogether.

Anybody have any thoughts?

I think I would give the oral meds a chance along with the low carbing and see what happens. I'm also wondering if Dr Baltazar might have some advice since he's on the cutting edge of the DS and type 2 diabetes resolution. His contact info is on dsfacts.com.

--gina

Pre-op, I chose insulin over orals if at all possible and had since I went on insulin in 2002. Prior to insulin I was on 4 oral meds and the side effects were alarming.

Insulin, at least is somewhat natural in that it is something your body needs anyway.

Best way to keep your dose low is to low carb, a la Dr. Richard Bernstein. He's a well known type 1 endocrinologist. Here is his wikipedia article: http://en.wikipedia.org/wiki/Richard_K._Bernstein
http://www.avvo.com/doctors/richard-bernstein-2818442.html

I would ALSO request your endo test you for LADA. It looks like type 2 at first but is actually a version of type 1. And if that is the case, oral meds are worthless....

Liz

My surgeon said that generally most people are off their diabetic meds immediately after surgery but he told me that he would not guarantee that I would be off mine that soon or even that I would be off them at all.  So I continued to stay on my diabetes medication for almonst a year after I had the surgery.  I was on two types of insulin and two types of pills before my surgery.  Wth monitoring from my general practitioner and strictly following my prescriptive medicines I eventually got off my diabetes medicine but I was told that I should still be mindful of what I put in my mouth.  I still monitored my sugar for another 6 months until I was consistent with my bloodwork on normal blood sugars.  There are a lot of factor that can affect your blood sugars, such as stress and minor illnesses.  I am no doctor but I would just keep an eye on what you are doing and follow precisely what you doctor orders.  I do not know how long you have been diabetic but it did not happen over night and it will not stablize over night despite what you have been told especially if it was out of control in the begininning.  Good luck and I know it will get better, just hang in there and be patient!