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on 11/10/10 10:25 am - Woodbridge, VA
You may or may not need to continue the medication after your VSG. Most can reduce or even discontinue meds simply because the early post-op diet is SO low in carbs that it is much easier to control blood glucose levels. Your endo/PCP/surgeon should work with you to determine the best course of action for your treatment of your diabetes.
Christine
Even a year out things are going well - and counting :)
Type 1 diabetic for 25 years - pumping for 12 years.
Could of been years that your pancreas has been putting out so much, it finally is fatigued, metabolic issues, so many things can cause sugar flucuations - been sick, etc - go to the doctor and then get back on track - that would be my recommendation - but hey I'm just someone on the internet
lol on 11/6/10 1:15 am - Woodbridge, VA
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:
- 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
, , , , , , ,
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
, , , , , , , , , ,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.
I've gotten rid of 3 of my 4 meds on my 2 week preop diet. As my NUT said, diabetes doesn't go away, your blood sugars just become stabilized, thus putting diabetes in remission. If I were you I would take a hard look at the amount of carbs and what kind you are eating each day. Could be a fluke or not. Also, any stress you're under etc. Don't let it go too long.
I was just talking to my co-worker and with her Cancer she also has to remind everyone. We do so need to take care of ourselves as noone else is.
Wish you the best.
I wish you the best and if you have any questions please feel free to ask. I dont know everything but would love to help.
Debbie
