XPost: Type 1 Diabetes after getting the Duodenal Switch
When I was researching surgeries, I found a lot of info about Type 2 diabetes and RNY, but almost nothing about Type 1 diabetes and any kind of WLS. So I wanted to post my experience so far as a way of paying it forward to Type 1s and Type 2s looking at their options.
The day of surgery, I was very nervous about leaving my beloved insulin pump behind in my luggage. I had taken a dose of Lantus two nights before surgery, and was giving Humalog injections every four hours starting the night before surgery. (I couldn't sleep, so it wasn't a big deal to give one at 3am, trust me!)
The hospital put me on IV insulin. By the second day post-op, I was taking one-fifth of the amount of insulin I had taken the day before surgery. In other words, I was taking about 160 units/day pre-op, and suddenly was down to 30 units day. It was surreal. And just to add to the weirdness, my post-op blood sugars while in the hospital stayed right around 100, like a rock.
Once I got home and started eating, my basal needs did creep up a bit. I had a few weeks where I was inching up the basal rates, and I was worried about it. I thought, crud, I didn't get rid of insulin resistance! But after those few weeks of adjusting, I found the right basals, and they have stayed stable since then.
What amazes me nearly every day is how tight a range I maintain with my blood sugars, and it's almost effortless. I stay within 50 points of my fasting blood sugars--a miracle to me, when I could easily streak off into the over 230 range at the drop of a hat before surgery. Plus, my fasting blood sugars are almost always around 120 or a little under. THat may not be the ADA ideal, but it is a vast improvement over the scattershot I had before.
I have some days in my cycle that lessen my insulin resistance, and end up dropping overnight into the 60s and 70s. I'm going to have to do a monthly chart and see if I can predict when those days will be. So far, that's my biggest complaint, at least as far as diabetes is concerned.
Oh, and a mere six weeks after surgery, my A1c dropped from 7.3 to 6.8. I absolutely cannot wait to see what it is when I go back to the endo in September.
I am thrilled to answer questions via private mails, about being a Type 1 and doing WLS, or about being a Type 1 and the duodenal switch in particular. And of course, I'd love to start a dialog in this forum, too.
The day of surgery, I was very nervous about leaving my beloved insulin pump behind in my luggage. I had taken a dose of Lantus two nights before surgery, and was giving Humalog injections every four hours starting the night before surgery. (I couldn't sleep, so it wasn't a big deal to give one at 3am, trust me!)
The hospital put me on IV insulin. By the second day post-op, I was taking one-fifth of the amount of insulin I had taken the day before surgery. In other words, I was taking about 160 units/day pre-op, and suddenly was down to 30 units day. It was surreal. And just to add to the weirdness, my post-op blood sugars while in the hospital stayed right around 100, like a rock.
Once I got home and started eating, my basal needs did creep up a bit. I had a few weeks where I was inching up the basal rates, and I was worried about it. I thought, crud, I didn't get rid of insulin resistance! But after those few weeks of adjusting, I found the right basals, and they have stayed stable since then.
What amazes me nearly every day is how tight a range I maintain with my blood sugars, and it's almost effortless. I stay within 50 points of my fasting blood sugars--a miracle to me, when I could easily streak off into the over 230 range at the drop of a hat before surgery. Plus, my fasting blood sugars are almost always around 120 or a little under. THat may not be the ADA ideal, but it is a vast improvement over the scattershot I had before.
I have some days in my cycle that lessen my insulin resistance, and end up dropping overnight into the 60s and 70s. I'm going to have to do a monthly chart and see if I can predict when those days will be. So far, that's my biggest complaint, at least as far as diabetes is concerned.
Oh, and a mere six weeks after surgery, my A1c dropped from 7.3 to 6.8. I absolutely cannot wait to see what it is when I go back to the endo in September.
I am thrilled to answer questions via private mails, about being a Type 1 and doing WLS, or about being a Type 1 and the duodenal switch in particular. And of course, I'd love to start a dialog in this forum, too.
Jenn
Type 1 diabetic, 26 years
With great power (the DS!) comes great responsibility.
HI Jenn my name is Ashley i am type one diabetic. I was ten when i was diagnosed. I am thinking about wls surgery but cannot decide which one to do. Did your insurance cover deod enal swich. How did you dicide which one to do. I am very confused. I dont know i dont want to do the bypass because of all the complications. Lapbend is safe way to go. But i dont know much about the deoudenal switch yet. Just like you i cannot find any information over the interent about type one diabetics about wls. PLEASE give me more information. THANK YOU.
(deactivated member)
on 8/20/09 1:46 am - Woodbridge, VA
on 8/20/09 1:46 am - Woodbridge, VA
Lapband is safer as far as initial surgical complications, but later on, the band can slip, erode your stomach, disconnect from the port...not to mention you need to go in for fills and unfills to try to find the often elusive "sweet spot" of restriction. If you think restriction only (without malabsorption) is all you need, I recommend researching the VSG (if you haven't already).
Many insurance companies do now cover the DS, including Medicare. I had mine covered by Aetna and was about to have it covered by BCBS of NJ until my company switched insurers on me!
Many insurance companies do now cover the DS, including Medicare. I had mine covered by Aetna and was about to have it covered by BCBS of NJ until my company switched insurers on me!
Hey Ashley,
My insurance (Aetna) did cover the DS.
Here's my thought process to the DS: I went into my surgeon's seminar thinking I wanted a lapband. But as Dr. S went through the excess weight loss stats, I thought, crud, I could lose only 50% of my EW with the lapband, and I would still be morbidly obese! Plus, lapbands are not risk free. Some of the complications include erosion of the stomach by the band, band slippage, port turning, and the fact that you will have to eventually get a new band, because they last about 10 years, tops.
The RNY scared me because of dumping, what with having to treat low blood sugars as a Type 1. When taking insulin, you will have lows at some point or another, and that means treating with sugar, juice, or other sugar-containing carbs--exactly the things you need to avoid to prevent dumping. While somewhere between 30 and 40% of RNY patients dump, there's no way to tell if you're going to dum*****t before you get the surgery. Also, the 10-year weight stats for the RNY are not as good as for the DS--something like 65% EWL on average. That was still not enough weight loss for me, with a pre-op BMI of 55.
The DS has the highest cure rate (98%) for Type 2 diabetes. No, we're not Type 2, but our excess weight is a related to, essentially, having Type 2 on top of Type 1. So the insulin resistance part of your diabetes will get resolved by the DS. In Europe, some Type 2s are having the intestinal switch part of the DS to cure their diabetes. (In case you don't know, the DS involves having part of the stomach removed, but leaves the pyloric valve intact. The intestinal part re-routes your small intestines so that you have less available space, if you will, to absorb nutrients. There are some great explanations of it on www.dsfacts.com)
I have been stunned by how much better my control has been, once I got to about 5 weeks post-op. My blood sugars used to be all over the map, even with an insulin pump and testing 6 to 8 times daily. Now, I test about 4 times and nearly always am under 150. I see something over 240 maybe once a month, where I used to see that at least 3 times a week.
You can learn all about the DS on the DS forum here on OH, plus also check out dsfacts.com--there are lots of peer-reviewed articles there. The folks on the DS forum are a pretty happy lot, because their surgery allows them a good quality of life post-op. You get the most "normal" eating and lifestyle with a DS, of all the WLS.
Please let me know if you have more specific questions!
My insurance (Aetna) did cover the DS.
Here's my thought process to the DS: I went into my surgeon's seminar thinking I wanted a lapband. But as Dr. S went through the excess weight loss stats, I thought, crud, I could lose only 50% of my EW with the lapband, and I would still be morbidly obese! Plus, lapbands are not risk free. Some of the complications include erosion of the stomach by the band, band slippage, port turning, and the fact that you will have to eventually get a new band, because they last about 10 years, tops.
The RNY scared me because of dumping, what with having to treat low blood sugars as a Type 1. When taking insulin, you will have lows at some point or another, and that means treating with sugar, juice, or other sugar-containing carbs--exactly the things you need to avoid to prevent dumping. While somewhere between 30 and 40% of RNY patients dump, there's no way to tell if you're going to dum*****t before you get the surgery. Also, the 10-year weight stats for the RNY are not as good as for the DS--something like 65% EWL on average. That was still not enough weight loss for me, with a pre-op BMI of 55.
The DS has the highest cure rate (98%) for Type 2 diabetes. No, we're not Type 2, but our excess weight is a related to, essentially, having Type 2 on top of Type 1. So the insulin resistance part of your diabetes will get resolved by the DS. In Europe, some Type 2s are having the intestinal switch part of the DS to cure their diabetes. (In case you don't know, the DS involves having part of the stomach removed, but leaves the pyloric valve intact. The intestinal part re-routes your small intestines so that you have less available space, if you will, to absorb nutrients. There are some great explanations of it on www.dsfacts.com)
I have been stunned by how much better my control has been, once I got to about 5 weeks post-op. My blood sugars used to be all over the map, even with an insulin pump and testing 6 to 8 times daily. Now, I test about 4 times and nearly always am under 150. I see something over 240 maybe once a month, where I used to see that at least 3 times a week.
You can learn all about the DS on the DS forum here on OH, plus also check out dsfacts.com--there are lots of peer-reviewed articles there. The folks on the DS forum are a pretty happy lot, because their surgery allows them a good quality of life post-op. You get the most "normal" eating and lifestyle with a DS, of all the WLS.
Please let me know if you have more specific questions!
Jenn
Type 1 diabetic, 26 years
With great power (the DS!) comes great responsibility.
(deactivated member)
on 9/2/14 11:05 pm - Turkey
on 9/2/14 11:05 pm - Turkey
Dear jen
What was your c-peptide level before the operation? I mean did you have any insulin reserve in your pancreas?
My wife is type1 diabet. Actually she was type2 in the beginning. But she lost all of her insulin reserves in her pancreas? Can she have any benefit of having ds operation?
Patients are able to eat larger portions than other bypass surgeries because of a larger stomach size and the pylorus, a stomach valve located at the bottom of the stomach, usually bypassed by other bariatric surgeries, remains intact. The intact pylorus also eliminates the possibly of ulcers, blockages, and dumping syndrome, a condition in which the stomach empties its contents into the small intestine too quickly, causing cramping and nausea, ulcers, and blockages.
Health is important!
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