Sliding back toward being diabetic- suggestions?

While many get their diabetes under control with the sleeve, there are others whose bodies are much more stubborn.  For complete remission, you will need to do a bigger change to your metabolism.  The DS has the best stats for long term remission, so good that they call it a cure (and do the switch in EU as treatment for diabetes).  The good news is that with your sleeve, you're halfway there already.

Hi Valerie,

I do realize the DS is a "stronger" surgury in most every regard- better to diabetic control/remission, better weight loss, better long term (less regain)... it is a fantastic option for many. In my case I ruled it out because my ADHD butt has a real struggle remembering vitamins. I am not intentionally noncompliant, just struggle gettiing them in. It took me a few years and only just now got the last of my deficient areas into normal ranges (except D, but missed it only by a hair). I cannot even imagine what my deficiencies would look like under the DS. If I develop full on diabeties then I will have to take a very hard look at what the better big picture option is- the ravages of being diabetic versus the risk of nutritional deficiences and the consequences that result. 

Knowing that about yourself is a good thing, because it would kill you...but so will diabetes.  You're back to the old pre-surgery efforts, then...just with a smaller stomach now.

My sugars were very bad this summer and I went back on metformin.  I found out that my antidepressant was affecting my levels somewhat but the main culprit was fruit.  I saw a diabetes nutritionist who wanted me to drop to 1/2 fruit per day.   Fruit is my nemesis but now my sugars are back down and I am off metformin again.  I stick to 1/2 apple per day with a few walnuts/cheddar or PB. Eating fruit as a stand alone snack is a no no.  You have to eat it with protein.  I might have strawberries in my protein shake for breakfast but that is all for the day.  Being back on meds scared the heck out of me.

The problem with complex carbs and those of us who are very insulin resistant is that they are still glucose in the blood stream, and glucose raises serum insulin.  High insulin levels trigger the glucose to be stored (as fat), as receptors on fat cells use insulin for this purpose.  It directs fat cells to convert and store glucose and amino acids...not just fat.  The reason low carb diets work so well is that glucagon then becomes the dominant digestive hormone.  Glucagon actually raises blood sugar (insulin lowers it), which is why people with hypoglycemic symptoms on low carb diets resolve these after 1-2 weeks - the glucagon is more active in the system.  Glucagon actually regulates your blood sugar through fat burning.

Sorry, I was a biochem nerd before I was a counselor!  Anyway...

I am not far out from my sleeve, however after doing a lot of research it seems I would always have to stay under 50-75g a day, even with exercise.  Diet has far more influence than exercise on blood sugar though, from a biochemical perspective.  At any rate, after talking to multiple surgeons, some of whom do the DS (at U of C), I stuck with the sleeve because I'd still have to limit carbohydrate somewhat to keep my diabetes in remission, and I was unsure that I could guarantee my compliance with the vitamins.  The curative effect of the DS is interesting, but I'd never have been able to keep up with the vitamin regimen.  I already struggle now with the piddly VSG vitamins.  

I'm also worried about "carb creep" - coffee still has carbs, even black, for example, as do Splenda packets, etc.  A week ago I tallied the half percentages of carbs in the eggs and splenda I was eating - scallops are apparently carby, too.  There was a stealthy extra 15g a day.  Eesh.  I'm much more careful now.

No matter what, though, I hope you find the solution that works best for you.  Good luck :)