Has anybody had high blood sugar reading after having gastric bypass 5 years ago and losing a bunch of weight and being told you are non- diabetic now and dont have to taker meds for it start having high readings after two meter check?.  Thanks  Gail(also hardly any weight gain)

You are not alone. Longer-term studies on RNY are showing that the remission of type 2 diabetes is not always durable, and the diabetes symptoms can return after 2+ years even without significant weight regain. I believe one study showed approximately 10% of RNY patients whose type 2 had seemingly disappeared early out ended up seeing their diabetes return at 5+ years out. Unfortunately, it is not the cure for everyone that some believed or hoped it would be.

Hi, Could you plase tell me where you read this study.  I would defintely like to read it Thanks.

I have a sort of running thread on here of data regarding WLS for type 2 diabetes:
http://www.obesityhelp.com/forums/diabetes/3751535/If-you-are-Type-2-and-considering-WLS/

I also try to keep such information updated in my profile. Here's what I was referring to specifically:

Potential For Resolving Type 2 Diabetes With Bariatric Surgery

ScienceDaily (Mar. 11, 2009) — As the incidence of obesity-induced type 2 diabetes mellitus continues to increase worldwide, medical research indicates that surgery to reduce obesity can completely eliminate all manifestations of diabetes.

In a study published in the March 2009 issue of The American Journal of Medicine, investigators analyzed 621 studies from 1990 to April of 2006, which showed that 78.1% of diabetic patients had complete resolution and diabetes was improved or resolved in 86.6% of patients as the result of bariatric surgery. The primary risk factor for type 2 diabetes is obesity, and 90% of all patients with type 2 diabetes are overweight or obese.

The dataset included 135,246 patients where 3188 patients reported resolution of the clinical and laboratory manifestations of type 2 diabetes. Nineteen studies with 11,175 patients reported both weight loss and diabetes resolution outcomes separately for the 4070 diabetic patients in those studies. Clinical findings were substantiated by the laboratory parameters of serum insulin, HbA1c, and glucose.

Researchers observed a progressive relationship of diabetes resolution and weight loss as a function of the operation performed: laparoscopic adjustable gastric banding, gastroplasty, gastric bypass, and biliopancreatic diversion/duodenal switch (BPD/DS). Gastric banding yielded 56.7% resolution, gastroplasty 79.7%, gastric bypass 80.3% and BPD/DS 95.1%. After more than 2 year post-operative, the corresponding resolutions were 58.3%, 77.5%, 70.9%, and 95.9%. In addition, the percent excess weight loss was 46.2%, 55.5%, 59.7% and 63.6%, for the type of surgery performed, respectively.

Writing in the article, Henry Buchwald, MD, PhD, Department of Surgery, University of Minnesota, states, "This systematic review and meta-analysis demonstrate that bariatric surgery has a powerful treatment effect in morbidly obese persons with type 2 diabetes; 82% of patients had resolution of the clinical and laboratory manifestations of diabetes in the first 2 years after surgery, and 62% remained free of diabetes more than 2 years after surgery (80% and 75% for the total group). Randomized clinical trials comparing surgery and medical therapies for type 2 diabetes are urgently needed. Considering the potential benefits for millions of people, such trials should assess the risk/benefit ratio of surgery in less obese (BMI 30-35 kg/m²) populations, as well as in the morbidly obese (BMI>35 kg/m²) population."

---

Journal reference:

1. Henry Buchwald et al. Weight and Type 2 Diabetes after Bariatric Surgery: Systematic Review and Meta-analysis. The American Journal of Medicine, Volume 122, Issue 3 (March 2009)

From the article referenced above, here is some longer-term data clearly organized:

	Initial Type 2 Resolution Rates	Resolution Rate at 2+ Years Post-op
Banding	56.70%	58.30%
Gastroplasty	79.70%	77.50%
RNY	80.30%	70.90%
DS	95.10%	95.90%

Also, this one:

http://www.soard.org/article/S1550-7289(09)00733-3/abstract

Analysis of factors associated with durable remission of diabetes after Roux-en-Y gastric bypass

 

Silas M. Chikunguwo, M.D., Ph.D., Luke G. Wolfe, B.S., M.S., Patricia Dodson, M.S., Jill G. Meador, B.S.N., Nancy Baugh, B.S.N., John N. Clore, M.D., John M. Kellum, M.D., James W. Maher, M.D.

 

Received 27 May 2009; received in revised form 31 October 2009; accepted 3 November 2009. published online 12 November 2009.

Abstract 

Background

Data on the durability of remission of type 2 diabetes mellitus (T2DM) after gastric bypass are limited. Our purpose was to identify the rate of long-term remission of T2DM and the factors associated with durable remission.

Methods

A total of 177 patients with T2DM who had undergone Roux-en-Y gastric bypass from 1993 to 2003 had 5-year follow-up data available. T2DM status was determined by interview and evaluation of the diabetic medications. Patients with complete remission or recurrence of T2DM were identified.

Results

Follow-up ranged from 5 to 16 years. Of the 177 patients, 157 (89%) had complete remission of T2DM with a decrease in their mean body mass index from baseline (50.2 ± 8.2 kg/m2) to 31.3 ± 7.2 kg/m2 postoperatively (mean percentage of excess weight loss 70.0% ± 18.6%). However, 20 patients (11.3%) did not have T2DM remission despite a mean percentage of excess weight loss of 58.2% ± 12.3% (P <.0009). Of the 157 patients with initial remission of their T2DM, 68 (43%) subsequently developed T2DM recurrence. Remission of T2DM was durable in 56.9%. Durable (>5-year) resolution of T2DM was greatest in the patients who originally had either controlled their T2DM with diet (76%) or oral hypoglycemic agents (66%). The rate of T2DM remission was more likely to be durable in men (P = .00381). Weight regain was a statistically significant, but weak predictor, of T2DM recurrence.

Conclusion

Early remission of T2DM occurred in 89% of patients after Roux-en-Y gastric bypass. T2DM recurred in 43.1%. Durable remission correlated most closely with an early disease stage at gastric bypass.







And another study with similar findings, though a smaller group of subjects...  

Re-emergence of diabetes after gastric bypass in patients with mid- to long-term follow-up

Mary DiGiorgi, M.S., M.P.H., Daniel J. Rosen, M.D., Jenny J. Choi, M.D., Luca Milone, M.D., Beth Schrope, M.D., Ph.D., Lorraine Olivero-Rivera, D.N.P., F.N.P.-B.C., Nancy Restuccia, M.S., R.D., Sara Yuen, M.S., McKenzie Fisk, M.S., William B. Inabnet, M.D., Marc Bessler, M.D.

Received 27 May 2009; received in revised form 22 September 2009; accepted 23 September 2009. published online 02 November 2009.

Abstract 

Background

Studies have shown that type 2 diabetes (T2DM) improves or resolves shortly after Roux-en-Y gastric bypass (RYGB). Few data are available on T2DM recurrence or the effect of weight regain on T2DM status.

Methods

A review of 42 RYGB patients with T2DM and ≥3 years of follow-up and laboratory data was performed. Postoperative weight loss and T2DM status was assessed. Recurrence or worsening was defined as hemoglobin A1c >6.0% and fasting glucose >124 mg/dL and/or medication required after remission or improvement. Patients whose T2DM recurred or worsened were compared with those whose did not, and patients whose T2DM improved were compared with those whose T2DM resolved.

Results

T2DM had either resolved or improved in all patients (64% and 36%, respectively); 24% (10) recurred or worsened. The patients with recurrence or worsening had had a lower preoperative body mass index than those without recurrence or worsening (47.9 versus 52.9 kg/m2; P = .05), regained a greater percentage of their lost weight (37.7% versus 15.4%; P = .002), had a greater weight loss failure rate (63% versus 14%; P = .03), and had greater postoperative glucose levels (138 versus 102 mg/dL; P = .0002). Patients *****quired insulin or oral medication before RYGB were more likely to experience improvement rather than resolution (92% versus 8%, P ≤.0001; and 85% versus 15%; P = .0006, respectively).

Conclusion

Our results have shown that beyond 3 years after RYGB, the incidence of T2DM recurrence or worsening in patients with initial resolution or improvement was significant. In our patients, a greater likelihood of recurrence or worsening of T2DM was associated with a lower preoperative body mass index. Before widespread acceptance of bariatric surgery as a definitive treatment for those with T2DM can be achieved, additional study of this recurrence phenomenon is indicated.

Hi Jil, Thanks alot!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  Gail

Hi, Gail,

That just sucks!  Just wondering,do you exercise? Hope it is a temporary situation for you.

Thanks
Lori

Thanks everybody for for your thoughts on this scare for me.  I just wanted to tell you both that it turned out ok.  I was scared to death to have that dreaded disease again!!!!!!!!!!!!!!!!!!!!!!!  However the readings were false(taken not fasting) and when taken fasting and also had the A1C
and all is good------------------I am not diabetic   and when i heard those words from my doctor I was the happiest camper !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  Gail

Hi!  I had the rny gastric bypass in December, 2003.  I see my pcp every three months and he runs labs each time.  The last 2 visits my Hgb A1C has crept up to 6.1 and 6.3 indicating the recurrence of T2DM.  My T2DM was poorly controlled on massive amounts of medication and a very strict diet ~ 3 oral hyperglycemics, 3 types of insulin, fish oil, lipitor, tricor and niaspan.  Even with all of that medication, I ended up with severe pancreatitis, an 11 day stay in ICU and a total of 16 days in hospital.  That was the clincher for my decision to have the bypass.  This is really frightening. How do you treat T2DM following the GB?  How do you treat hypoglycemic episodes (which I frequently had before my surgery)  My blood glucose levels were erratic and brittle to say the least.  I am almost 9 years post op and this is the first time I have had elevated A1C readings.  My highest wieght preop was 297.  My lowest weight postop was 193 and I stay right at 212-213 currently.

Thanks,   Carol

How high were the readings when you took them? Just because they weren't fasting doesn't make them false - it just means you should be looking to fall into an appropriate post-prandial range instead of fasting range, depending on how long it had been since you'd last eaten. Fasting glucose values are usually the LAST to go out of whack - problems (such as impaired post-prandial readings) typically begin to occur long before the fasting values are high, so it could still be a bit of a warning that you need to be very careful with your diet and exercise.