5diabetics who have had VSG

Hi-

I've read the forums, including the rarely active diabetic forum. I have to decide soon if I want the sleeve or the RNY. The consulting doctor is pushing the RNY as automatically the best for any diabetic. I'm with Kaiser, am almost through the options program, and have dropped my A1c to 6.9. I've been on basal insulin

Aargh, my tablet posted when I want ready! I'm a type 2, on basal insulin for about 2 years, diabetic for 12. I'd really like feedback from diabetics who chose the VSG over the RNY. Did your doctors argue against it? Are you happy with your choice? I'm worried with the RNY I'll be banned from NSAIDS for life, and I'm allergic to most pain killers. And about the complication rate for RNY. Thanks for any feedback.

Just FYI - the latest recommendation is that sleevers stay away from NSAIDS for life too.  

I am a type 2 diabetic and was on 2000mg Metformin and 10mcg Byetta daily for about 7 years.  No insulin.  I went home the day of surgery off all my meds.  My A1c (that I just had today) is 5.5.  I've held between 5.1 and 5.5 for the last two years with no medication.  I had the sleeve in May 2013; you can see my weight stats below.   

Having said that, how quickly your diabetes goes into remission depends on how long you've had it, if you are insulin dependent and how long you've been taking insulin.  What I've read on here is that it can take longer for insulin-dependent diabetics (type 2 only of course) to go into remission and get off their meds.  And for those that have been on insulin for decades, they may never get off all of it.  However, even being able to reduce the amount of insulin you take is a HUGE bonus.  

I've seen and read about type 2 diabetes going into remission whether they get RNY or VSG.  If I was an insulin-dependent type 2 diabetic with over 100 lbs. to lose, I probably would have gone with RNY.  But I'm glad I went the route I did.  

Tracy, I hadn't heard that about NSAIDS for sleevers.  The last I was told, quite awhile back by one of the surgeons at a support group, was that there was concern.  He recommended using the ibuprophen liquigel caps, as they go into the system faster and don't sit in the stomach dissolving as long as regular tablets, which is where the concern is.  I'll have to check into that.  I use NSAIDS sparingly, just on dance day for my knee.  Recital is in a little over a week, then I'm having my knee replaced this summer, so hopefully I won't need to take the med on dance days next year!  :)

There's a lot of misunderstanding about NSAIDs, even among surgeons. The problem isn't their sitting in the stomach, it's that they have a side-effect of thinning the mucosal lining of the digestive tract. They work systemically, which means it doesn't matter HOW you take them---orally, injected, IV, rubbed on, they still have this effect.

NSAIDs pose some risk for anyone who takes them, even non-ops. Those risks are, *maybe*, SLIGHTLY increased after the Sleeve or the DS. The big increase in risk comes with the RNY, because of the huge, blind, remnant stomach it leaves behind.

Bottom line, everyone needs to evaluate the pros and cons for their individual situation and make their own decision based on that.

I had type II diabetes, and my surgeon was also pushing RNY.  I had been diagnesed with it in 2004 and my A1C when diagnosed was 11.7 - don't know how long I'd had it, but was borderline in the mid 90's when going through infertility testing/treatment.  I was on Metformin 500 mg twice a day, and things were under control, so I still chose VSG.  I had my last dosage of the med the day before surgery, and have not needed it since.  My A1C's since surgery have all been 5.0-5.3.   Mary

The new recommendation is that NSAIDS be avoided with any WLS.  It does not matter how long NSAIDS  "sit in the stomach, dissolving" because the problem with NSAIDS is that they get in the blood stream and they thin the stomach lining, causing ulcers.  It does not matter whether you take them orally, intravenously, in a patch on the skin, etc.  The medication STILL ENTERS THE BLOODSTREAM CAUSING THE STOMACH LINING TO THIN, CAUSING ULCERS!!!!!

I was pre-diabetic, but very close to being considered diabetic. On a fast my glucose levels were not horrible, but in the 120s. 12 hours after VSG my blood glucose level was down to 88 and I have been between 80 and 90 for every draw since. Even my random pulls after eating are exceptional! My A1c has evened out between 5.0 to 5.5.

I was with Kaiser and my doc gave me the choice, though he did emphasize that RNY was the gold standard surgery for putting type 2 diabetes in remission. I also had some mild heartburn issues that concerned him, but they weren't bad enough for him to make the call for RNY.

I'm very happy with my VSG. I also know people who are very happy with their RNYs. You really need to know yourself and what you want farther down the road. You will make the right choice for yourself.

I'm a type2, took 2000MG  Metformin, Byetta, and Glimeride. The surgeon encouraged the sleeve and said that his personal experience is that the sleeve patients do just as well in resolving Diabetes and he felt the official statistics had not yet caught up. There just wasn't as much data for the sleeve as for the bypass. I have a sleeve.

I'm 6 months out, my last A1c is 5.6 and my sugar this morning was 81. I am on no medication.

Overall, they both do a similar job in putting diabetes to bed, averaging around the 85% remission rate. If you want better odds, you go with the DS which runs in the 98-99% remission range, but you have to fight Kaiser to get it because they usually don't have the capability to do it in house (my doc does the DS for the NorCal Kaiser patients who get through the gauntlet, so it is possible if one wants to go that route.) Some who go for the RNY and later experience a recurrence of their diabetes, typically thru regain, revise to a DS to correct the problem, but it's a much tougher job the second time around. Historical note - the DS started as a surgical treatment for diabetes, to which the sleeve was added to make it a weight loss procedure, that's why it tends to work better in that regard than the other procedures.

Given the similar performance between the RNY and sleeve in both overall weight loss success and diabetes resolution, I would prefer the sleeve (gee, imagine that, being on a sleeve forum!) as it has fewer downsides than the RNY and if a revision is necessary, it is much easier to revise to a DS from the sleeve than from an RNY.

The NSAID issue is largely reflective of the RNY bias of the bariatric field in general - most bariatric surgeons make most of their income from the RNY (tho that is shifting as the sleeve gains market share,) and much of the RNY advice is generalized to all WLS procedures. The RNY has characteristics specific to it that preclude the use of NSAIDs; while we all may be sensitive to their use (even normal, non-WLS people should use caution with them,) that sensitivity is nothing like the problem that RNY patients can have with them - definetly a shades of grey thing rather than black and white.