I have chosen the type of surgery I want, which is RNY, but recently it was brought to my attention that a lot of RNYers become hypoglycemic.  I have been reading blogs, (current and older ones), that seem to say so. 

I thought I should ask some people that have had RNY themselves to get some feedback.  I am diabetic, but, it is controlled with the lowest dose of Metformin currently.  My fear is that I will become hypoglycemic after RNY.  Can any of you tell me how common this is for patients having this type of surgery?

Also, other than the differences in the surgeries (procedures), what are the differences in RNY and DS patients?  I don't know too much about the DS other than the little bit I just read on DSfacts.com and what I got out of that is that both types of surgeries have malabsorbtion with the need to take supplements the rest of their lives.

Both surgeries offer restriction.  There is no "dumping" for the DS patients, but there is however, loose stools/gas for the DS patients.  Can anyone tell me what else I should know about the DS, other than it is a riskier procedure?  Oh, and on dsfacts.com, it did seem that the stats it had listed as far as complication/mortality rates were very close to RNY.  So, what I have listed above, basically, are the only differences for the overall outcome between the two?  Please help me understand.  ThankYou!!

Before you decide if you should have a DS you need to research and learn everything there is to know about it.  A good place to start is dsfacts.com.  It is a good surgery, superior for weight lose and maintained and resolution of comorbidities but at the cost of a higher level of malabsorption and the need to pay very close attention to supplements and lab work.  Yes, you need to do that with a RNY, too, but with the DS neglecting to do so could be much more dangerous, even fatal.  Many surgeons won't perform the DS or have stopped doing it because there is so much lack of compliance and with it so many complications.  You need to really know yourself well and know you can stick with a rigid schedule of supplements and lab work.  This can also get spendy so you need to know you will be able to afford this now and in the future because this is for life.  This goes for the RNY, too.
Also, the DS isn't a free ride.  There are consequences for eating poorly.  Many who overindulge in refined carbs find themselves with frequent diarrhea and gas and wallpaper peeling odor, so you need to watch what you eat.  Like the RNY and the possibility of dumping, there is the possibility of these side effects so you need to choose your poison, so to speak.  It can be very embarrassing.  Like dumping it doesn't happen with everyone but it is a risk you need to accept.
As far as the hypoglycemia, it definitely isn't pleasant.  Ironically, I started having it a few months ago out of the blue and just as suddenly it stopped.  I totally avoid sugar and refined carbs and eat every few hours so that may be why but even what it happened I found that as long as I was prepared and kept snacks handy it wasn't as terrible as I feared it would be.  Not fun but for me anyway easily managed.
No matter what surgery you choose simple carbs will be absorbed 100% so there is always the possibility of regain if you don't address the causes of your obesity.  If you have a problem with carbs then that needs to be looked at or you are at a disadvantage no matter which surgery you choose.  If you love protein like meat, cheese and lots of fat then the DS may be a good choice.
Do your research, find a surgeon who does the surgery and talk to them and make an informed decision.  One other thing, I don't know where you live but you may need to travel since there aren't a whole lot of surgeons who do the surgery and after care can be very difficult due to the fact that not a lot of health care providers are familiar with the surgery.  You will need to do a lot of education both of yourself and others to get the best care and you need to be assertive to get the labs you need as often as you need them.
Good luck with your decision.

My sister had the DS nine years ago.  She went from 320 to 160.  Her surgeon told her once she got to her lowest weight she would put back on fifteen to twenty pounds and stay there and that is exactly what she has done.  Nine years later she is 185 and has been for years.......but here is the kicker, she eats what she wants.  SHe does have episodes of hypoglycemia at times so just because you have the DS there is know guarantee of that not happening .  The DS is more of an Atkins kinda eating plan.  Eat all the fat and meat you want and you want gain a pound.  Once you get far enough out (with my sister it was two years) you can eat the breads and noodles and sweets, but in moderation.  The DS has the best stats for keeping the weight off long term and the highest rate of diabetes going away and never coming back (Type II).  On the flip side,   it is the riskiest surgery with the most complications and there aren't a whole lot of Dr. to choose from and some insurance companies want cover it.  It is also the surgery where there are the most post surgery vitamins that you have to take.  Alot of surgeons who did preform this surgery don't anymore because of patients not complying with the post op nutritional requirements and ending up with permanent life-long damage to there bodies because of it.  (My sisters surgeon is one of them)  Of course this can happen with the RNY also, its just not as likely.  Hope this helps.

Two of the biggest differences is that you can take NSAIDS with the DS and you preserve the pyloric valve so there isn't the risk of a stricture since you don't have a stoma.  I think you can eat and drink at the same time too due to that.  You also don't have a blind stomach, they toss out the remnant stomach.  Downside to that? If you ever need to reverse you can't.  Upside?  That's why you can take NSAIDS.  

I am 2.5 yrs out and I don't have hypoglycemia, none of the folks in my support group do either.  I think that when you look online you're not going to come across blogs or postings that say I don't have it.  If you don't have it then obviously you're not talking about it.   

I suspected the RH but it wasn't confirmed for me until I was 3 years out.

Reactive Hypoglycemia (RH) is the main thing I'm  going to talk about from what I've read (I'm not a surgeon, not a doctor, not in the medical field)...

When you get LARGE, you eat more. When you eat more, your body has to process more food, which you needd to eat in order to even maintain your large size. To process more food, your body has to release more insulin into your system to deal with the greater volume of food.
 
For some folks, the pancreas isn't up to the task, and you get type II diabetes. This is often put into recession by either DS or RNY. The stats are that there is a slightly better results with DS over RNY, but basically if you're someone who has it put in permanent recession by DS and get DS, or by RNY and get RNY it really doesn't matter which one does better, so long as it does better for you. I don't know what makes some RNY patients do better than others. I'm sure there's some correlation between those who had diabetes longer, or whatever. But I have ZERO info on it because I never fit in this category. This subgrouping can get RH, I've heard about it, I don't know how likely it is, but it makes sense that their pancreas hasn't had a pleasant road, so it might not react to massive changes in diet.

For some folks (like me) the pancreas actually grows MORE insulin producing ccells (I read a cool article/study about this) and to my way of thinking, if they could figure out WHY or HOW to stimulate a pancreas to produce more insulin producing cells they could help Type I diabetics to get a more productive pancreas and overcome diabetes. But in any case, for some folks, the pancreass grows more insulin producing cells to deal with the overload of food. When the body loses weight, and needs a lot less insulin, the body is mostly good about toning down the insulin, but a surge of carbs makes the body think "Avalanche of carbs, coming right up, insulin cells, start your engines!!!" and when there isn't enough sugar in the system for the insulin to consume, it drops your blood sugar below acceptable levels and you have a blood sugar crash.

If you are this type of person (like me) I don't believe that I would have escaped RH no matter what TYPE of WLS I had. I'd still have RH, and I know folks who have had the DS (and the VSG and the Band) who have RH. RH is an issue for ANYONE who loses an extreme amount of weight. (as of this morning I'm at 189 pounds below maximum). So having a DS doesn't make it a given that you'll avoid RH. And except for a limited number of folks whose RH is freakishly out of control, most people control the RH with diet. I do. I worry about two planned vacations where my control over food will be limited, and I've done a lot of reading up on low and high-glycemic index foods so that I make smart choices from those available to me (one vacaation is 3 weeks long, that's a long time to be away from my chosen menu, and it's going to cost $5/lb for anything more than 65 lbs I bring with me for the trip, so that is severely limiting.)

The DS is a very powerful, very strong surgery. I always think of it when I think that a person needs to bring the Big Guns in to solve the obesity problem. Realize also that I didn't have it, and my words could easily be taken as biased. YOU need to hear why people are happy with their DS or happy with their RNY and try to figure out based on your knowlege of SELF if one or the other is For YOU or not For YOU.

I've heard some DS people say they dump. I know for a fact only 3 out of every 10 RNY people dump, so dumping should NOT be a consideration (though I hate it, and at times wished I didn't have WLS because I hated the dumping so much, but since I had teh RH, controlling diet for that almost entirely eliminated dumping from my consciousness. I still dump.... I just haven't because that is all down to what i eat)

The DS takes longer in the operating room. It's more malabsorptive. You have to supplement with vitamins for life after either procedure, but can run into severe deficiencies somewhat quicker if you are bad at supplementation and have the DS. My personal opinion (for whatever it's worth) is that the DS is "the big guns" and if your obesity situation is that you have "only" 100 pounds to lose, you might not want to go big guns. Some folks get the VSG (whch is the first half of the DS procedure) and if the restriction isn't enough, they later do the "switch" part of the VSG which makes it into a DS.

When I was making my mind up, I looked at a lot of statistics, and RNY was always going to be my choice. I'm a math teacher so I listened to the "success rates" between RNY and DS and calculated that at surgery day when I had 140 left to lose, I might get about 10% shy of goal compared to DS, and I asked myself if DS was worth it. Were those 14 lbs worth posssible issues with loose stools, exacerbation of GERD, and an extra six month insurance fight to get them to pay for it? Or could I accept that I might not get to goal, cure the GERD, and deal with constipation instead. As a teacher, I didn't want flatulence. I needed the GERD cured, and that was my decision point about ANY WLS in the first place, and I hate fighting bueracracy. It was an 8 month fight just to get RNY, gettin DS.... I didn't want that fight. But that was MY issue, MY body, MY needs.

YOU must decide based on your body.

I personally think one of the best ways of deciding isn't by asking people who had the surgery if they liked it. It's by reading the day-to-day good and bad on each forum, reading the bad is especially enlightening. If people wnat to convince you they focus on the good. But you have to read the BAD on both, and decide which BAD you could handle more..... for some folks the DS near-insistance on having to eat a lot of fat to be healthy.... well that's heaven. For some folks dumping is the biggest incentive to HAVE surgery.

for me, I don't have an investment in your choosing my surgery or DS or VSG (if GERD wasn't an issue, I would have retrospectively chosen VSG). I wouldn't suggest anyone have the LapBand because I've heard too many horror stories about it, and the stats are awful, why would anyone do that to themselves. But YOU have to live in your body, so YOU have to choose.

Good luck making your choice. It's a hard one to choose which alteration to nature you need in order to overcome obesity.

Thank you all for your responses, they were very helpful.  I will continue to read people's blogs, both on the DS and RNY Forums.

I did not know that GERD may possibly become worse with the DS.  Definately is a very serious thing for me to consider as I have had it for the last 5+ yrs. and it only is getting worse with the weight gain.

Thanks Again!