Bypass or Lap Band - Type 2 Diabetes

Hi.. I have type 2 diabetes and am in the final stages of the bypass surgary, however I don't know which surgery is best for me.  Lap Band or Bypass?

I'm 5'2 and 206 lbs..

Any advise?

Between the two, bypass. Considering ALL options, DS. Please see my profile and/or this thread:
http://www.obesityhelp.com/forums/diabetes/3751535/If-you-ar e-Type-2-and-considering-WLS/

Hi Valerie.  I also have/or had  type 2 diabetes.  My doctor told me that with bypass, a horomonal change occurs and that 82% of patient who had the bypass no longer have diabetes.  Since the lap band does not bypass the part of the small intestines that causes the hormonal change, the best you can hope for is remissiion.  Check with your doctor.  Hope this helps.

Julia

Hi All,

Thanks for replying.  My doctor advised me by losing weight I will or can put my diabetes in remission.  She's also advised me that the bypass will work better.  My main concern is that I lose over 85 lbs.. which in my eyes I believe I would be too thin.  I'm 5'2 and currently weigh 206lbs.  I want to get healther, not look REALLY skinny.  I would be happy at 130lbs, and that would mean I only need to lose 75lbs. 

The DS works even better for diabetes than RNY, and about 10% or more of RNYers whose diabetes goes into remission after their surgery see their diabetes RETURN at 2+ years after the surgery.

Normal weight loss will help you CONTROL your diabetes, not cure or resolve it.

While the RNY has about an 84% chance of putting type 2 into remission (sometimes only temporarily), the DS has up to a 98.9% CURE rate - in fact, as patients get further out from the surgery, MORE see resolution of their diabetes instead of some seeing it return like with the RNY.

Your PCP likely doesn't even know what the DS is, and if you're seeing a surgeon who doesn't perform it, they probably won't tell you about it. Please do lots of research on your own.

Oh, and I know of patients who had a DS at BMI of only 35-38, and none of them have wasted away to sickly thinness! With both the RNY and the DS, there are steps you can take to stop losing weight if need be.

Jillybean... Thanks so much for all the information.  I'm hoping to make a decision soon.  :-)

My understanding is that once you have diabetes," you have it period!" The question is if you can keep it under control or not.  I had a long talk with my pcp about my decision between Lap and RNY which one is best for diabetes and she told me I will always have diabetes regardless of which surgery that I have, Its which surgery will help me to be able to control my diabetes without meds.  My insurance will cover only Lap or RNY and of the two RNY is the choice for me to be able to control my diabetes without meds. Some people have done just as well with Lap. also I have two women at my support group meetings that have had the Lap and lost over 100 lbs. each and resolved their issues with diabetes and stayed at goal for 2 yrs. or more and still control their diabetes without meds.  But on the average most people do better with the RNY.  I don't know anything about other wls because my insurance only covers the two.  Hope this helps you to make an informed decision my surgeon was very helpful as well as my pcp.


Good Luck
God Bless

Sherry

Your PCP is not correct when she says that once you have diabetes, you always have it. That's what Jillybean was trying to say--the DS actually CURES Type 2 diabetes. It does this by changing the physiology of the small intestine. In the DS, the upper portion of the small bowel is bypassed, and that is the area where the insulin resistance hormones are generated. In Europe, several surgeons perform the intestinal switch portion of the DS as a CURE for Type 2 diabetes.

Take a look at these links if you are interested in understanding the science behind this cure:
http://www.obesityhelp.com/forums/diabetes/3751535/If-you-are-Type-2-and-considering-WLS/ (contains links to study by Cosu, Noya et al). "Conclusions: Our long-term results suggest that in carefully selected patients suffering from serious hypercholesterolemia or type 2 diabetes with insulin reserves still at an acceptable level, and with BMI 30-40, DS without gastric resection can be proposed as a surgical treatment for metabolic diseases but not for obesity."

Also see this discussion from Dr. Husted about the difference in how the upper small bowel and lower small bowel process food differently, from a metabolic perspective:
http://www.obesityhelp.com/forums/revision/4098880/BPD-DS-ER NY-Confusion/

Buchwald, H. Bariatric Surgery, A Systematic Review and Meta-analysis. JAMA, October 13, 2004-Vol 292, No. 14

	Gastric Band	RNY	DS
Diabetes Mellitus	47.9%	83.7%	98.9%
Hyperlipidemia	58.9%	96.9%	99.1%
Hypertension	43.2%	67.5%	83.4%
Sleep Apnea	95%	80.4%	92%

So if a patient's aim is to cure their Type 2 diabetes, the best surgery for doing so it the DS. That's not opinion, that's what the studies say.

Yup, once you are diagnosed with diabetes there is no cure.  Diabetes will always be there, just not going to have to treat it the same. But for LIFE should always be aware of it. Most often folks don't know it until it's too late and they are having complications.

There are good treatments, but no cure.

The DS can be a cure. It isn't a cure for everyone, but it can happen. I personally know of more than one individual who was type 2 and post-DS can actually pass a glucose tolerance test as non-diabetic (not just have normal fastings and A1Cs and be off meds).