WLS and diabetes

I came to this forum in hopes of getting help. My husband has had Type II diabetes for 22 years now. At present he is having all kinds of trouble with his vision having numerous surgeries zapping those blood vessels. A few years ago he lost a bunch of weight but has now gained all of it back plus. He weighs 275 and his BMI is 38.3. He now complains about his lower back hurting. (I'm scared it's his kidneys) He is on glucophage, glyburide, avandia and byeta insulin. What I would like to know, if he could have WLS, would this stop his diabetes? Would he stop having the trouble with his eyes and some of the other problems he's having with the diabetes. I am so scared for him, I'd hate to see him go blind or worse. Peg

Hi Peg, I wish I could tell you yes the surgery would stop the diabetes but it won't. It may however put it into remission. One thing for sure it will greatly improve things. I have been diabetic for 19 years. I had surgery on January 3. Before surgery I was on Actos, Metformin and lots of Humulin Insulin both N and R. Since surgery I have been off the oral meds and my insulin dose has been going down and down. I used to take: Morning: 50U of Humulin N and 12U of Humulon R Bedtime: 40U of Humulion N and 10U of humulin R And my blood sugar was still not in good control. Now I am in great control and I only take: Morning: 20U N Bedtime: 5 U N I hope to be able to stop the night time dose soon One thing, does your husband want this surgery? It is not a "magic pill" and will require alot of effort on his part. He will still need to watch his diet and to excersie in order to loose the weight and to control his blood sugar. If I can help in any way please email me at [email protected] Regards, Ronna

Ronna, Thanks for responding. Those who have responded have said the same thing. He may just go for the surgery if he is approved. He's kind of a LW, for a man. He just weighs 275 and for him to lose 100 lbs., he'd look like skin and bones. I'm in the application phase of my surgery and maybe if he sees what it's like for me maybe he will go through with it. He used to exercise a lot. Back in 1999 he had to have a couple of stents put in and went to cardiac rehab. He got down to 200 lbs. and was looking real good. But with all of the medication (he was on avandia and lantus together and gained all of his weight back) He has no energy, he is tired all of the time. Right now he does try to walk about 1 mile a day. I think that it is terrific that your medication has been cut down so much, that is wonderful. I know it is not a cure, I'm just trying to buy him (and me) some time. Thanks Ronna, Peggy

Hi Peggy - I had the lap band - gastric banding surgery done on July 13th - I am two weeks out, lost 18 lbs so far and counting. I was on byetta, 1000 mg of Metformin 2 x per day plus Glybiride 2 x per day. My sugars ran 180 on average. Now, post op, I am no longer on byetta, only on 500 mg of Metformin 2 x per day and still on the Glyberide (sp?). My sugars are running around 130 now. This is two weeks post op - I am 43, was 246 lbs with Type II. I have been told by the doctors and surgeons that I am working with that there is a 80% chance of remission of my diabetes with the lap band surgery. Not sure if the RNY - gastric bypass surgery has better stats or not. I have also learned that remission after wls is dependent on many factors - age, use of insulin, type I or II, how pooped out your pancreas is, etc. There are no gaurantees but that is why I have done this surgery. I do think that weight loss surgery can at least be a tool to help many individuals get their blood sugars under better control even if they are still taking meds - that in and of itself is a blessing. Hope this helps - Nancy G.

Nancy, Thanks for responding. It never ceases to amaze me all of the great stories that you hear about WLS. My husband and I had a talk about WLS today and how he felt about me having it. He said if the doctor said it can help me medically to feel better then he is all for it. I'm hoping that my surgery will be a success and then he can look into getting it done. Congratulations on your surgery, glad to hear everything is going great for you. Good luck on a smooth recovery. 18lbs. in 2 weeks, that sound pretty good to me. Before you know it you'll be looking terrific, I bet you already feel better. Thanks again, Peg

As with most things in life -- there are no guarantees. I had RNY surgery March 7 of this year (5 months and 2 days ago). I'm down 80 lbs -- and my bmi has gone from over 47 down to 34. Unfortunately, my type 2 diabetes has remained as stubborn as ever to treat. Additionally, even on clear liquids and no fat, my lipid levels went through the roof when I stopped my vytorin. I feel great, and am getting lots of comments on how good I look -- but all the same, my goals for having surgery were to improve some health conditions. I'd still do it again -- there was every reason to have surgery -- and no good reasons not to.....but I AM slightly disappointed.

Hi Cheryl, I had my wls June 27 and am also a Type II diabetic on insulin and the maximum dosage for cholesterol and other meds. The good news is that I have lost 40 pounds so far but am battling the blood sugar highs. It seems that any time I have more than two saltine crackers and a very little amount of canned splenda fruit (carbs a day), my bs the next morning is in the 140's to 150's. Like you, I'm disappointed that, so far at least, my diabetes is still active and going strong. I'm still on alot less insulin a day (in am only) than I was before my surgery, but it seems now I'm having to take a little insulin at bedtime as well to help bring it down. You should be thankful that you're still not carrying around all of that excess weight anymore and can now lead a more active life. I know my goals for having this surgery were the same as yours...like you said, there are no guarantees....We'll just have to hang in there and try to be as healthy as we can. Hugs, Jan

Hi Jan... It seems we're all wired differently. About 2 weeks after surgery, my endo had me start using fast-acting insulin -- thinking I would only need a little bump now and then. (prior to surgery I was on metformin and byetta) Well, insulin resistance is a very nasty thing -- I was requiring 40 units of novolog per carb exchange. I had no problem with the shots, etc.... but I stopped losing weight and actually GAINED 8 lbs. I quit taking the insulin and insisted he find another option which would allow me to continue weight loss. He consented to let me go back on byetta -- which appeared to work well. My fasting and 2-hr post-prandials were all in the 100-110 range -- BUT --at 30-60 min after almost any meal, I was at 275-350. A1C has remained at 6.6-6.7 since at least a year before the surgery. Tried precose for 4 weeks - but the GI side effects would not subside, so we're trying metformin again. If this doesn't address the immediate post-prandial levels, I know the doc will want me to add some form of insulin again -- but there will have to be a lot of hard talking on his part to convince me to take something that has proven to make me gain weight in the past. ::::::::SIGH:::::::::::: Thanks for the support!

Nancy G. I also am preop lap band -sch for Oct. I'm currently on Metformin 1000 mg 2x day. Question: Do we have to crush the meds post op for them to pass thru the stoma? or is there a liquid version of the oral meds? I've not really gotten a clear answer from my surgeon...he refers me back to PCP...and PCP says we'll discuss it later.....closer to surgery date....but I'm concerned. Any advice/experiences shared is appreciated!

Getting your Blood glucose levels in better control is not only good to reduce Infectiosn but also to prevent Diabetic retinopthay from the sudden weight loss and sudden lowering of HA1c's....... see: Retinopathy progression, sudden lowering of HbA1c , etc, http://medweb.bham.ac.uk/easdec/retinopathyprogression.htm My A1C was over 13....... when I went ionto surgery. In the past two years it went down to 7.9 HOWEVER I now have had 4 episodes of Retinopathy adb 4 laser surgeries. I ma facing steriod injections as well a eye surgery, to STOP further loss. ANY DAMAGE already done is permant! I have less than 80% vision in my left eye and less than 50% in my right eye. Please ask for a referral to an Opthamologist as well as a diabetic specialist to lower the A1c slowly. BEFORE surgery. Lisa