After years of researching and working on my personal issues I have to agree that Diabetes is much more complicated than most believe -it's not always this neat, clean Type 1 or 2, lose weight and all is well kind of thing. 

I too learned a lot through my own reading and researching and advocacy for myself.  I had RNY in October of 2010 not so much for weight loss, but to get better control.  I was diagnosed with gestational diabetes in 1981 and it never went away. 

Since then I have run marathon's (under training with dietician and physical trainer specializing in diabetic patients) been on every med and finally meds and insulin and well, it just kept getting worse (my resistence). 

My highest weight (I'm 5'4") was 224 after childbirth and the lowest I could get was 190 and I was miserable when I got to that weight.  I researched and thought about surgery for 5 years before comitting to the procedure as a way to hopefully stem the tide of complications that were just starting with my diabetes. 

I weighed 188 lbs the morning of my surgery and 36 hours later and 12 pounds heavier (water I'm sure) I was off all insulin and meds.   It took 9 months, gym 3 times a week (again working with a very specialized trainer) and today I am 135 pounds and so far, it is working.  My fasting blood sugars are alway right around 100, 3 hrs are lower than 116.    

Yes the weight loss was an added benefit, but definitely not the goal of this surgery.  So, from the beginning, I knew I had to have something where my digestive system was impacted - thus RNY.  Another factor, my cholesterol and Tri's are all in normal range now - it took about a total of 6 months for that to happen.  Really good for me as I could not tolerate any Statin that the doctor tried with me. 

I knew the day I had my surgery that my poor little Pancreas had been "putting out" for many years and that at some point in the future it might not be able to put out enough, but the hope for me is that if that day comes and I am once again in a place where insulin is a necessity - I hope that the resistence is still gone - that is why I am maintaining as healthy a life style as I can and thanking God that this worked for me and praying that they figure out EXACTLY what physiciological change in the body is making this work for at least those people who fit my "profile". 

The best part, I now understand what "runners high" is - I feel great most of the time and that never happened in my entire life (really - even as a young Extremely active person).   I always participated in sports and always went home and fell down dog tired - wondering why other people felt so great afterwards.

My biggest complaint right now  . . . I don't fit in exactly anywhere.  My support group is great, but even there I have experienced prejuidice - you only had to lose a small amount of weight . . . and well forget about anyone else outside of the Bariatric Surgery World, as far as they are concerned I somehow "cheated" my way to weight loss, they don't even want to hear about how good I feel because my insulin now works right.   That part is very frustrating.  I wish there was a support group just for Metabloic sydrome patients . . . lower BMI before surgery . . .  maybe someday.

Lily

I might also try to challenge on the basis that, if it is not defined anywhere, how are you or your insurance company supposed to know when you either have met the criteria or you haven't?  I have other thoughts about ways to circumvent this, but they are probably best kept to myself....  :-)  Best of luck.

I'm so glad I found this post! I am getting clearances for the rny, and on the pump. I am on U-500, 40 units max right now, with a basal of 1.75. I notice my levels are lower than before, but still not in control. I am very insulin resistant.

My concern is how to use the pump after surgery. Will I even need it? I go to see my endo again in March. He yelled at me to have the surgery because he said there is nothing more he can do, except increase the insulin. It has caused me to gain weight, and I have neuropathy in my feel and ankles, and am on temporary disability from work because of the pain. Also, a previous heart condition has returned, and I have just learned from the pulmonolgist's prescreening, I have emphysema.  I am starting to be scared they won't even do the surgery.

I don't have to do a pre surgery diet, but who wants to eat anyway? I don't and haven't eaten much of anything for years, but the pounds just stay and increase. I am so frustrated and tired of all of these problems, and the pain really doesn't help matters.

If your insurance has this stipulation, then this is a question for them.  I am sure they have this defined within the restrictions.  it's probably an hba1c number, but it might really be any criteria.  I'd call them and ask them to define it - or talk to your HR department.  Good luck!

I am a newly diagnosed diabetic - type 2 who the doctor just recently placed on metformin 1000 mg twice a day.  My hgb alc was only 6.1 but my fasting glucoses X 2 were elevated 143 and 157.  I am trying to get insurance approval for the sleeve and meet all of the criteria for the insurance company but have been denied because my employer has stipulations in this coverage which states that you have to be uncontrolled on medications for diabetes and hypertension.   I have just been placed on meds for both in order to see if I can satisfy this criteria but of course, the meds have to be unsuccessful at treating these conditions.  My question is what criteria would indicate that the metformin is not controlling the diabetes or is an unsuccessful medications???  Thanks!