Type 1 diabetes

Hi everyone. New here and have a date for surgery on Nov. 15, 2005. I am type 1, on an insulin pump and can't find much info on others like me. Anyone out there either pre or post-op? Any information would be helpful. A little nervous about insulin requirements, lows, carb-counts, etc. I have a Great diabetes doctor and surgeon but neither can say they have had patients with a case like mine! Thanks! Karen

Hi Karen! I'm have Type I diabetes; I've had it since I was 15 years old, I'm 45 now. I am pre-op, too. I'm hoping to have the duodenal switch; just waiting for my insurance to approve. I originally wanted to have the RNY, just because I knew two people (not diabetics) who had success with it. When I went for my initial consult with the surgeon, he steered me toward the DS. He told me he would perform whatever surgery I wanted, but felt that with the DS it may have a better effect on my blood sugars and reduce my insulin dosages because he feels that Type II diabetics have better results with the DS. He also feels that with the DS you can eat more "normal" and this would help with low blood sugar. He felt that if my blood sugar went low it would be easier for me to consume the right amount of juice in order to elevate my blood sugars. This was a big factor in my deciding to have the DS because my husband was worried about me going low and not being able to consume enough to get my sugar back up with the RNY. He told me that the DS will not cure my diabetes as it will in a Type II diabetic, but that it will greatly improve it and will also totally eliminate by hypertension. That's about all I know right now. You are lucky to have a surgery date already. Did you have to get insurance approval or are you a self-pay? I'd be interested in knowing what your BMI is and if you have any other co-morbidities. You can let me know here or send me an email! Good Luck and let me know how you do on 11-15! Karey

Hi Karen, I am also a type 1 diabetic on an insulin pump just starting my journey (although researching for over a year). I will be having Lap Band surgery if all goes well, my first appointment is Nov. 17th. The other type 1's I have heard from have told me the most important thing is that your endocrinologist be on board with you and must work closely with both you and your surgeon. There are many horror stories out there about type 1's but many sucess stories. The most important thing is to let your endo know you will be counting on his/her advise. My endo does not endorse any WLS because not enough studies are done on type 1's. Typically we are not obese so we are rare cases so he will not support me. With that being said, I have been looking for an new endo and my Bariatric group has one who will work with me in the meantime (they are 2 hours away so I can't keep seeing him forever). Good luck on your surgery. You will be in my thoughts and prayers. Nancy K

I forgot to mention that I'm a very brittle diabetic and have been my whole life. I spoke to my surgeon (Dr. Hess, Boston, MA) and he has told me it's ok for me to have my pump on and working during my surgery. I've had two heart attacks 13 months ago and it was removed during my hospital stay. My sugars bounced even more on shots, so this time, I'm not letting anyone disconnect me from my 'lifeline'. My endo is wonderful and I've got tons of questions for him. I'm still scared stiff, but if the rest of the professionals I meet in this program are anything like Dr. Hess, I'll be at ease instantly! Good luck and keep us posted!! Marie

Hi Karen!! I'm a type I on a pump too. I've had the big D 35 yrs now. I too, am pre-op, but have just started the process. I was told DS surgeries are not performed on the East coast (I'm in Boston). I was told the RNY would work best for me regarding my blood sugars. This is confusing to me as I'm very concerned about my sugars crashing. I'm looking forward to getting into the support groups and talking with the nutritionist Dr. Hess' office has lined up. I'm still very much on the fence about even having this surgery, but am looking forward to learning more about myself through the programs. Let me know how you make out!! Good luck, and I hope your recovery is quick! Marie H.

Thank you each of you for your replies to me. I was very excited to see other type 1's out there and especially on pumps!!! Karey, Nancy, Marie, low blood sugars are my biggest concern also. My husband is also afraid of me getting so low I can't come back up. My endo. doesn't seem too concerned as I can usually 'sense' my lows coming on and he has assured me we will start out on barely any insulin and tweak as needed. He is the one that first usggested the surgery and boy was I against it! Util I did A LOT of research on all types of surgery but like I mentioned, never found anything on type 1s and the success or failures. I meet with my endo. 1 week before surgery to go over these and he said he will visit the hosp after my surgery, even though it is 1 hour from his office! I too wanted the lap band because of how it can be adjusted but my insurance would not cover. Like I had $24,000. just lying around to spend on this! I have Blue Cross ppo, and surprisingly had no problems getting approval for RNY and after changing surgeons. I of course had to go through all the testing, psych. evals and yes, I have a few other health concerns. I weigh almost 250 and am 5'7", have mild hypertension, mild sleep apnea, had depression. I say 'had' because I was on meds for awhile but found the side effects worse than the problem itself! I agree that we are the minority when it comes to being overweight and types 1s. I get people that tell me just to loose weight and I won't be diabetic anymore. Like they know the difference! I keep reassuring myself that this is a learning experience as I wait and will have the surgery. My sidekick and lifeline, my pump, will always be with me but it won't have to work nearly as hard because of the decrease in insulin. Marie, I agree with you about NOT taking off my pump. My surgeon told me I will need to but I told him no; even if they want to turn it off during surgery and if I have to put the site in my arm, I will not go back to shots during my stay. Too many ups and downs. Isn't that why we have the pump to begin with? I'll keep you all posted in the coming weeks. Same with each of you, too.

Karen, Can't wait to hear how everything goes - I will be interested from a type1 pump patient to find out everything! Good luck to you and I look forward to keeping in touch. I noticed most of you have much lower BMI's than I do, I am 5'0 and weigh 225. I can't wait to do something about myself! You will be in my thoughts and prayers. We minorities have to stick together and learn from each other. Hugs, Nancy K from CT

Hi Nancy, Im' close to your ht/wt and BMI...I'm 5'3" and am hovering around 210 this week. I hate how my weight fluctuates so much! There are times when I want this done NOW and others where I'm just not sure because of my diabetes and none too great healing record. Plus, I've a friend who died post-op from a lack of good medical care. There are so many variables. Good luck with things and I'll be checking out this forum more!! Marie H.

I just found out Saturday that my BCBS PPO has denied my claim for surgery. I'm trying to have the duodenal switch, but they said they would pay for no kind of WLS for me. I'm bummed. I'm going to fight them though and go for the appeal. They say it's not medically necessary for me! I have diabetes, high blood pressure and just found out my cholesterol is high. We have a history of diabetes and heart problems in my family. My dad, who has diabetes, had triple bypass surgery last year and two of my grandparents have died of strokes. I just don't know how they can say it's medically unnecessary for me. My BMI is 38; I'm 5'1" and weigh 204 lbs. Good luck to all of you!

First of all, WOW to all the Type 1'ers....as I was doing research 3 yrs ago, it was extremely hard to find any and I was in the same boat trying to get answers...thank GOD for this website. We need to all stick together, as we are the minority. I had Open RNY 1 1/2 yrs ago, I've been Type 1 diabetic for 10 yrs, gained over 100 lbs from insulin resistance and 4 yrs ago went on the pump. I also had high cholestrol, sleep apnea. My endo wasn't onboard with my enthusium for gastric bypass, so I saw my surgeon's endo at the hospital. Its very, very important to have an endo that knows you before surgery, knows you're requirements and history. I didn't wear my pump for surgery and was monitored with dextrose. My sugars we're up and down, but the hospital was able to manage them. I had no complications at all, and recovered nicely. Regarding insulin, you're requirements will be hardly nothing as you'll be on a liquid/puree diet for the first 6 wks...or whatever you're dr prescribes. I wrote everything I ate and let the endo decide on my requirements. I also had no problems with taking glucose tabs or milk for low blood sugars. OJ isn't good for a recovering pouch, possibly months down the road. Now, I'm on half the amount of insulin and with being able to exercise, my goals are getting better. I still have several low blood sugars if I don't eat enough carbs, but everthing is managable. I wish you all the best and if you have any questions, e-mail me and lets all please keep in touch!! Wendy 278/175/150