Question for post-ops re: Type II diabetes

I have a question for post-ops who were diabetic prior to DS surgery and whose conditions have been improved or reversed following surgery. How exactly did that improvement/reversal progress for you? What kinds of improvements occurred during what kind of time frame, and how did you and your PCP handle the reduction of meds during that period? (I have the same question re: improvements in blood pressure and cholesterol but blood sugar can be a trickier beast to manage, given the tendency to fade out when readings go too low.) Thanks very much. Alison pre-op

I'm wondering the same thing--specifically how do you keep from having LOW blood sugar when you can eat so little and so few carbs post op? LeaAnn Preebie

I was worried preop, but it went flawlessly. I worked very hard to get the diabetes very well controlled pre-op on diet, glucophage and avandia. Right before surgery my hemoglobin A 1C was 4.8. It had been higher, and they said they wouldn't do surgery if the HA1C was out of control. Glucophage and avandia were stopped by the surgeon a week before surgery. I ate very carefully (no carbs or sugars) to keep it from going too high before surgery. I never restarted the drugs. After surgery, my blood sugars never went above 110 or below 80. In the first few weeks, I ate at regular intervals (every 2-3 hours) almost all protein, very low carbs and no sugars. I tested it every day three times a day for the first few weeks and it never went high or low. I think eating at regular intervals kept it from crashing. I had a "midnight snack"--something pure protein before going to bed, and I woke up to normal blood sugars. Now, I'm eating every 3-4 hours, and the blood sugar levels are neither going high or low. I stopped testing when the PCP told me the HA1C was in the nondiabetic range. They do DS in Europe for type II diabetics who are normal weight, something about the intestinal bypass controls the blood sugar swings. I had the same expeirence with blood pressure meds. Never restarted them after surgeon stopped them. Blood pressure last week was 124/72 on no meds. My BP was never really high, just borderline. I'm lovin' this DS! Why isn't this front-page news, if DS cures diabetes? Nancy

well I was a type II diabetic and taking glucopage (spelling ???) during surgery my blood suger went up and they gave me shots of insaline (spelling again). I had my sugar checked every week along with my blood preasure, which I was on 3 different meds for before surgery now only one hopping to get off that one too.Had to fight PCP to take me off of the 2nd one. Dr.s right. I coulden't even shower my preasure would go so far down. hope all goes well with your surgery also

i believe the key is to know what and how the particular med u take works. a high gulcosse level is negative in a long term effect. but a low blood sugar is a medical emergency, so if u are not taking insulin or a insulin pushing drug such as starlix you will not be at risk for sudden hypoglyclymia or insulin shock ,sudden unconciousness or the like, your emt/ems at service, but talkto your doctor for further details. glucaphage (metaphormine) works by :This drug reduces the amount of glucose produced by the liver and absorbed by the intestines, and enhances insulin sensitivity by increasing peripheral glucose uptake and utilization avadia,too, starlix can get us into trouble. fast. starlix :Nateglinide lowers blood glucose levels by stimulating the release of insulin from functioning beta cells of the pancreas. Insulin release is glucose dependent and diminishes at low glucose concentrations.

Hi Alison, The Diabetes II issue was the main motivator for me in pursuing WLS - namely the DS. I was taking Glucophage, Avandia and insulin (Humalog and Humulin on a sliding scale basis) - usually about 110 cc daily. In addition I was taking Zestril and Norvasc for high blood pressure, Hydrochlorothiazide for edema, etc. My surgeon had me stop the meds about a week before. To my amazement, I left the hospital taking NADA! Talk about an instant resolve. I still test every morning because I still can't believe it's really GONE. It is usually between 94 and 104. I go in for my 6-month labwork this week so will have a handle on the big picture. Aside from the diabetes, the HBP went away - it's normal and this too was immediate. The edema went away also very soon and I was looking at my ankles that had come back into view. I never have those blood sugar highs and lows that used to trouble me. I am down 80 lbs in 6 months - no complications whatsoever which was tantamount for me because we live overseas (Abu Dhabi in the Middle East). I feel lucky and blessed and KNOW this surgery worked a miracle for me and I will never take it for granted. I play by the rules and use this tool wisely. I wish you all the best in your pursuit. Hugs, Kris

My blood sugars became normal immediately after surgery while in the hospital. I'm off my Metformin and Prandin, not taking any meds at all. These were stopped immediately before surgery and I didn't resume taking them. Hooray!

Thanks, everyone, for the replies -- they were very helpful. My Type II diabetes was out of control until very recently, when my meds were adjusted upward (glyburide and metformin) and added to (Actos), and now it seems to be good if I eat carefully (no sugar, low carbs --> good prep for DS). I'd like to lose the meds altogether, although my mother was far from obese at 5'9" and 135 pouds, and she developed Type II diabetes in her 50s. We'll see ... perhaps the meds can at least be reduced. I'm on three other drugs for high blood pressure, one for high cholesterol, and I'm 44. Pretty awful: I do hope, despite the recently out of control blood sugar, that I'll qualify for surgery this summer. I suspect I may need to show a good 3-mos. period of HA1C results, but I won't borrow trouble -- I'll just go to my education/initial consult with Keshishian this coming Thursday and find out what I need to do. Alison

Alison, Before my DS I had seriously out of control diabetes on four different meds. My fasting blood sugars were in the high 200s and low 300s. My doc wouldn't put me on insulin because I was already having little heart attacks, and she didn't think my heart could handle the weight gain that she felt certain that would come with it's addition. I was extremely diligent in attempting to control my blood sugars. I did the diabetic diet, I faithfully took my meds - but they got worse and worse as I got closer to time for surgery. Of course, I was in a wheelchair, and the diabetes was just the tip of the iceberg in terms of my co-morbidities, etc. My PCP was pretty sure that my diabetes would NOT be "cured" with the DS. She told me every time she saw me not to get my hopes up. I went to Spain, I had my DS with Dr. Baltasar on July 2, 2002. I weighed 365 pounds, and my fasting blood sugar the morning of surgery was 312. Surgery went flawlessly, I walked to the toilet within 3 hours of surgery, and I only asked for pain meds once after surgery. I was blown away at how low the pain was! The two days after surgery my blood sugars shot up in the 600s and 700s. Boy did that flip everyone out! I was, of course, put on insulin - for the very first time in my life. I started to think, "Well, looks like Marnie is right!" (referring to my PCP). By the third day my fasting blood sugar was 130. Go figure. By the fourth day, my fasting blood sugar was down to 120. Amazing. By the fifth day, my fasting blood sugar was NORMAL. It has been ever since. Thought my PCP was gonna pee her pants when I came home from Spain and told her that I was off of all of my diabetes meds. She was - and still is - completely blown away. Hope this helps some. Blessings, dina

My hubby is one of the people who had the DS no GR to get rid of his type 2 diabetes. He never had any meds post-op at all. He has no food restrictions and can eat literally anything he wants. Including sugar. He never had any problems PO. He tested regularly till one day he got the guts to really TEST the surgery. He sat down and ate 3lbs of peanut brittle over a 2 hour period and took his blood sugar. Normal. We donated his meter and testing supplies. He still has his A1C done with his bloodwork and that's normal too. Pre-op he had the normal diabetic hyperlipidemia and that is gone now. His cholesterol is very low. Dr Baltasar did his surgery LAP. A friend who knew about my husbands surgery introduced me to one of their friends who had been insulin dependant for more than 30 years. He is an opthalmologist and didn't believe he could ever be free of his excess weight and diabetes. He researched the surgery and then invited me out to dinner. He wanted to watch me eat! I told him to make it a good test so we went out to an all you can eat steak buffet. He went to Spain and had surgery. It took him a while to get off all the meds. He was down to only one dose of long lasting every night for quite a while. Now he is medication free. We talked a lot when he was a new PO and he monitored his sugar and adjusted his meds. He was very careful. My main concern was that he was going to over medicate but it all worked out OK. While I was in Spain with my sister and husband, we met a couple from Colorado. The man was there for an open DS. One day I was out in the hall taking a break when she came up and asked why my husband had surgery because he wasn't fat. I told her and she was amazed. She was a type 2 diabetic and borderline heavy. She was so impressed that she came back and had surgery herself 6 months later. She never had any meds PO and has no dietary restrictions. She has lost the weight she needed to lose and looks and feels wonderful. There's a good chance you will not need meds PO. If you do; YOU will have to manage your diabetes. Things will be changing quickly and you need to adapt. PCP's have no experience dealing with someone who is getting rid of their diabetes. Chances are they will think what you're telling them is impossible. You will need to temper your docs advice with your own common sense. Test often and change your dosages accordingly. Adhering to a certain dose of meds just because your PCP told you to is the quickest way to get in trouble. You will most likely end up overmedicating. Don't be afraid to take 1/4 or 1/2 a dose and test again. You can always take more if needed! This is probably a good topic to discuss with your PCP before surgery.