DS surgery in diabetic with BMI 31

HI,

I am a severe type 2 diabetic that has done every med and tx, diet, exercise for this disease and am presently on over 400 units of insulin per day and am still experiencing very high blood sugars.  I was referred by my endocrinologist to a surgeon to see about a gastric surgery to help control my diabetes.  I am overweight but not by much, my BMI is 31.  Would it likely be dangerous for me to get the DS or gastric banding done due to the weight loss I would experience with it and it not being reversible.  Has anyone else had this surgery done with a lower BMI?

Any info/advise would be much appreciated!

Sure they have.  The DS for diabetes has been done in Europe for ages.  My H had it done and his BMI was 27.  Because his BMI was low he had the switch only...and that is totally reversible.  Gastric banding is a restrictive procedure and won't help your diabetes and the weight loss is usually pretty minimal.  Gastric banding will give you little to no help with your problem.  A doc named Noyes wrote the only paper I've ever seen about this and his study was on patients who had the switch for diabetes.  He found they usually lose about 30lbs postop and then slowly gain it back over the next several years.  In Europe the majority of these surgeries have been done with short common channels so you do have to adhere to DS type vitamin/mineral supplementation.

Send an email to Dr. Aniceto Baltasar in Spain and look up his website.  He has done many of these surgeries.  He is a good man and I'm sure he will answer you, his website was very informative the last time I looked.  Dina McBride has a lot of info in this and probably the paper I talked about too.

If I was diabetic, I would do it in a heartbeat!!!  It was like a miracle, diabetes just gone!

Best of luck!

Thank you Patty for your advice!  I will look into this BIG time- all of your info.  The surgeon I saw in Edmonton told me about gastric bypass ONLY, he told me the banding would not be of any help for me.  I think the DS is my only option from the research I have been finding and I will ask him about it and see if that is an option with him at all.  I am happy to  hear that DS is reversible too.  The AY surgery sounds less promising than DS so I will see if he does it at all.

I would definately adhere to vitamin/mineral supplementation, I already have to do that.  My electrolytes have been out of whack for years now because my diabetes is so bad.  I got lots of complications from it too like neuropathies, optic nerve neuropathy and I am even going deaf from it due to nerve/circulation changes in my cochlea- which is not heard of with diabetes often.  It has really attacked my nerves!  I also have a weird angina too that they think is associated with the changes from diabetes- prinzmetals angina.  I know if I don't get this figured out soon I won't be around. 

I am SO happy I found this forum! 

Hi,

I do think the DS is your best option. No operation has a 100% cure rate but the DS gives you the best percentages. Before I started working toward the DS I was taking 90 units 70/30 humalin twice a day and metformin twice a day. I walked out of the hospital not needing any medication for diabetes anymore. I hope whichever path you choose that it works as well for you.

Good luck! 

Patty's advice was spot on. I very much doubt you will be able to get the DS, or the switch portion of the DS, anywhere in Canada with your bmi. It's very difficult even for MO and SMO people to get the DS in Canada, and I'm not aware of anyone in your province doing it. In the USA, you would probably not be able to get the DS due to your low bmi, and the switch portion for type 2 diabetes is being done only in limited research trials.

However, if you are willing and able to travel to Europe, you can get this done, and given the severity of your diabetes and the complications it is causing, I would say the sooner, the better. These complications will only worsen as time goes on, and it sounds like you and your doctors have done everything short of surgery to get your diabetes under control already.

The one thing the surgeon you spoke with got right is that gastric banding would be useless for you. It has a very poor track record even for weight loss and rarely resolves type 2 diabetes - worst statistics for diabetes of any bariatric surgery, which makes sense as it doesn't change the metabolism in any way, and what you need is metabolic changes. sure, losing down to a normal bmi might help you a little, but you aren't that much overweight and here you are with terrible diabetes, which means that your weight isn't the main problem, and your metabolism is. It would make no sense at all to have any operation that didn't address your metabolism. As far as gastric bypass goes, it has some metabolic benefits but not nearly as much as the switch portion of the DS. Given the severity of your diabetes, you are one of the people least likely to experience resolution of your diabetes with gastric bypass - and even for those who do appear to resolve with gastric bypass, for many it returns after a few years. This is almost unheard of with the DS.

Do more research, esp on the switch being done for non-morbidly obese people with type 2 diabetes. You will need to travel, and self-pay, but it will be worth it to get the right medical care to prevent worsening sequelae of diabetes and likely save your life.

Larra

You may find these threads interesting http://www.obesityhelp.com/forums/diabetes/3751535/If-you-ar e-Type-2-and-considering-WLS/

http://www.obesityhelp.com/forums/amos/4468495/DS-and-Type-2 -Diabetes-Predictive-Factors-in-CURE/

Thanks Everyone for your help.  I have been to Dr. Baltasar's website and emailed him.  I will be talking to the surgeon I was referred to about the DS but I am not confident he will do it on me.  Do any of you know how much it costs for this surgery in other parts of the world?

Thanks again for the info!

I got an email back from Dr. Baltasar saying he wouldn't do the DS on me- the only operation he recommended I try if my C-peptide levels are reasonable still is the Gastric Sleeve with Doudenal-jejunal diversion.  Has anyone had this surgery?