a1c 12.5 scard

i was Dx with diabetes at age 9, im now 24 i wiegh 256lbs im 5'6'' i have out of control diabete, i take 70 units of one insulin twice a day and 50 of anouther twice a day. my sugars are staying at 500+  my legs hurt and im depressed. i had been banded 2 time i lost 100lbs the 1st time. it had slipped and it was removed. few months later i was rebanded and that one slipped a month later, i cant lose the wieght by myself and i dont know what to do now. i suffer every day with sleep apeana, high blood pressure, neuropathy, chronich back pain and leg pain, i was in the hospital this past week with pancrititis and no i dont drink, and the endocrin in the hospital told me either i need wieght lose surg or a insulin pump, and that because im taking so much insulin im going to gain wieght, i feel like im stuck in a hole and cant get out. if you have diabetes and had a high blood sugar then you know how i am feelling, 569 is my sugar right now, i go to the hospital to get help getting it down and they are like you agian and i feel horrible i feel ashamed some time i wish that the sugar gose up so high i die... well i feel like  am die slowly..... i woulod try the band one last time but i dont know if i can get it agian so so so so sad
o yah metformin makes me real sick

I'm very sorry to hear this and I know you feel stuck in a loop that you can't get out of right now!  It's awful when you don't feel well and then feel so out of control. 

The first priority, in my opinion, is to try and get better control of your blood sugars.  Most surgeons won't do surgery on you, I would thin****il that is better under control.  Do you have an endocrinologist that you work with on a regular basis or is most of your care coming from the ER when in crisis?  If it's the ER, you are only going to get emergency, not long-term, care.  And that is going to keep you stuck in this cycle you are in.

You need a good endocrinologist to start working on this issue with you right away, and you need to commit yourself to working at this in a very focused and deliberate way.  It's probably going to take a while to bring everything down and under control and you might need to try a number of different medicines and methodologies (perhaps the pump) to get you there.  You will likely remain frustrated for a while, but your efforts will pay off if you and your doctor can work together.  Small steps matter and can lead to big things, but you need to sustain the effort, be honest with yourself and your doctor, and listen to direction and feedback from your healthcare team.

Yes, your weight will continue to go up with lots of insulin.  Believe me, I know that cycle well myself.  But, right now, you need to improve your control first.  Once that happens, then you can begin thinking about WLS surgery.  Perhaps you need to consider something more than the band?  I think it's probably too early to even go there.

Please find an endocrinologist.  And keep us posted. 

How's your diet? I'm assuming based on your age at diagnosis that you're a type 1 (possibly with also some insulin resistance now, so possibly essentially both type 1 and type 2). Most diabetics, even many type 1s I know, find a diet low in carbs to be VERY helpful in controlling glucose levels.

Get WLS. DS would have better long term control, but even RNY would immediately improve your levels.
Another band would slip too, since the last 2 did. Don't be afraid, jump in there and make a decision to live longer and healthier.
As for your levels now, I always cut out all carbs except in a low carb salad dressing and eat salads twice a day, and for breakfast eggbeaters with cheese. After about the third day, my fasting glucose level would be below 150, sometimes as low as 110. Then I would   add low carb vaggies back in with any meat, chicken or fish. All carbs are the devil for diabetics.
My A1c was around 11 before weight loss surgery. I did the salad and eggbeater thing to get below 10 for surgery.
Best wishes.
ETA: before surgery I took 90 units of Lantus once a day, 45 reg for  breakfast, 35 for lunch and 45 for dinner. Didn't help much without letting go of the carbs.

I agree.  I was originally planning on getting the VSG, but my surgeon's office explained to me that the RNY has almost a 90% chance of "curing" my diabetes where the VSG was only about 55%.  I know there's not real "cure", but that's the word they used. :)

My A1C usually runs around 10-11, so I can somewhat relate, though I was in my late 30's when I started having problems with not being able to control my blood sugar.

A low carb or "smart" carb diet would be a great idea also.  I went on South Beach last year and was able to get off my insulin until I started giving in to my cravings again and went off the diet.  Sugarbusters is another good one to try.  You'll want one that uses the Glycemic Index since that determines how fast or slow your body turns food into sugars.

I definitely think you should consider one of the other WLS, though.  RNY is the one I chose (DS sounds great, but just not for me) but it sounds like DS has a good chance of fixing the diabetes as well.

Good luck!
Jen

Jen: Do you know what diabetes type you have?  About 10% of those diagnosed with Type 2 are NOT Type 2 - they are what the literature and docs call Type 1.5 (or LADAs - latent autoimmune diabetes in adults).  The age of onset is usually around 30 and there are blood tests you can have to determine whether this is you or not.

The reason I mention this is that WLS surgery can greatly improve your overall control, but you will still function like a Type 1 diabetic and likely need insulin, albeit in smaller doses with better results.

I was diagnosed at 29 and have had diabetes for 25 years now.  I just had RNY in September and found out just about a year ago that I had LADA, not type 2.  I have gone off a lot of my oral meds and reduced my insulin.  But, I still need it.  My endocrinologists always thought that I didn't quite "fit" the Type 2 diagnosis, and frankly, I never really did.  I initially hoped that WLS would take this all away, but once I learned that I truly was a Type 1.5, I had to readjust my expectations for outcomes.  I'm glad I knew it before the surgery.

Totally agree with your statements that WLS is the only way to go for any type of metabolic intervention that can impact diabetes.  I never even considered Band surgery - it does nothing to change the way the body metabolizes food/calories.  

Best of luck to you!
 

I've always believed I was Type 2 along with insulin resistance.  I was also diagnosed in my early 30's, though, and I do have diabetes on both sides of my family.

I haven't heard of latent autoimmune diabetes before.  I'm going to go do some research on it now so I can see what tests I need to have done!

Thanks for the information!!
Jen

Hey Jen:
I didn't mean to cause you to question your type.  It's just that there is so little out there about the type 1.5's (LADAs), especially regarding the connection with WLS.  When I found out that for certain that I had type 1.5, it stopped me for a few months and made me realign my expectations for the surgery. 

I did the surgery for one reason - to improve my health and diabetes control.  The weight loss is an added benefit that it more visible to me and to others.  But the numbers that matter most to me are the ones on my glucose monitor! 

Good luck - sounds like your surgery is coming up soon.  You will feel SO relieved when you are on the other side of it. 
Best to you!

For most type 2s, "smart carb" diets are not enough. I was actually on South Beach when I was diagnosed with my type 2 - my fasting was in the 200s and A1C was 9.5. Those "smart carbs" were just as bad for me as a candy bar! The body will convert whole wheat bread to glucose just as it will a cup of apple juice or a handful of jellybeans.

I'm assuming you're a type 2 since no WLS will "cure" type 1...

And just as a point of information, the DS has the best long-term resolution rate for type 2 diabetes (approximately 98%), followed by the RNY (about 85-90% short-term, but about 10-20% of those resolved see their diabetes return at 3+ year after surgery). The VSG long-term stats are still up in the air since there aren't any long-term VSG stats available.

 My PCP was just telling me about intestinal sleeves.  While they are still in the early research stages, the results have been very good:  resolution of DM2, weight loss not quite on par with bypass, but better than the band.  Oh, and it's non-surgical, done endoscopically.     Not sure where you are located, but were I you I would not only speak with an endocrinologist, but seek out a bariatric program at a teaching/research hospital.  They would probably be best to inform you of procedures or trials that could be helpful considering the inability to control your diabetes with meds and other comorbidities.


http://articles.latimes.com/2011/apr/05/news/la-heb-diabetes-bariatric-sleeve-20110401

"...In the meantime, Kaplan suggested a one-year respite from diabetes could be valuable for obese diabetic patients who need to improve their metabolic function before they can undergo needed surgery or radiation therapy."

also see
http://www.weightlosstriumph.com/endoluminal-sleeve-non-inva sive-alternative-to-gastric-bypass-to-treat-obesity-and-diab etes.html