Question:
What advice for a person who still has diabetes after weight loss surgery?

One year ago I had gastric bypass surgery. I have been treated for type 2 diabetes for over 20 years. I was on Lantus, Byetta, Januvia, Avandia, metformin, and Micronase. I was also taking medicine for high blood pressure, high cholestrol and high triglicerides, and prozac and wellbutrin and synthyroid. My blood sugars were usually over 200. When I started on Lantus, I weighed 175 pounds. After five years I weighed 212 pounds. One year after surgery, I weigh 132 pounds. If I take no diabetes medicines, my sugars are in the 400's and 500's. With Lantus, I can get it down to 100, but I start to gain weight and also get a very increased appetite. I am currently taking 1 Januvia and two metformins daily and averaging 250 sugars. I know that I am in the minority of gastric bypass patients, but wonder if anyone has a similar experience after surgery and losing all their weight. I know that doctors have always suspected that I did not take my medicine and that I ate a lot of high carbs. Neither is true. I do have a very strong family history of diabetes. All four of my grandparents, my mother, all of her five siblings, and four of my siblings. My doctor says that perhaps some people cannot escape their genes.    — Mary Catherine (posted on November 23, 2008)

November 23, 2008
Perhaps you should go to your doctor and have your medications re-evaluated. Also make them recheck your thyroid; sounds like something other than the surgery. Blood sugars in the 400-500 range are dangerous. Sounds like your diabetes is out of control right now. You probably need meds and diet readjusted. Good luck but definitely see a doctor about all these problems. vinnigirl
   — vinnigirl

November 23, 2008
I am also Type 2 diabetic. Before surgery I was on 100 units of insulin per day, plus oral medications. Now, 4 months post-op, I only take 20 units of Lantus per day, and no oral medications. Blood sugars are perfect, 90-100. I have been under the care of an endocrinologist for 5 years. I emphatically suggest you see a diabetes specialist, an endocrinologist, to get your sugar under control - Those are some dangerously high numbers - I don't mean to scare you, but you need to take action! And if it means staying on Lantus, please do so. Take care!!
   — kimee

November 23, 2008
I agree with Kim, you need to see someone, I am a dieabetic yet I guess I had the RNY on 5 Nov, I am still on insulin but my sugars are down in the low 100's I had to go back into the hospital after surgury for high sugars and back on insulin guess your not the only one any more thought I was but bet there are more of us out there after all. good luck and see a doctor get it under control. Bill W.
   — bwauer

November 24, 2008
Yes...you are an exception to the to RNY /diabetes remission...Cure...or whatever you want to call it. We are all so different in how our bodies function OR malfunction, especially after a surgery. I have no answer for you, but I was a little concerned about what you said about gaining weight when your sugars were in a good or low range...as opposed to being higher... I KNOW so many of us fear weight gain more than anything....but after losing all the weight, would it be worth it to be thin if it compromised your health? See if you can get to the bottom of your problem with a specialist so you can be healthy AND thin...I don't know a thing about the meds you were or or are on, but maybe you need to try different meds for your diabetes or the others...and have a doc go over the ones you are taking and make sure they are not interfering with each other! I hope there is a solution and can get things under control! But be HEALTHY first! Because there is no use for being thin if you are going to be bed ridden because of complications of high sugars!
   — .Anita R.

November 24, 2008
I started to put more weight on when I went on lantis.I was at 94 units befor my lapband was put in I now am at 42 units. I think in my case lantis added to my weight problem.
   — stanwalker

November 24, 2008
I have talked with my surgeon, my family doctor and two endocrinologists. They were all stumped as to why this happened. The thyroid and everything else was perfect. My blood sugar was perfect after surgery from October until May. In May, my husband was diagnosed with cancer and we did not think he was going to make it. I was spending my days and nights at the hospital and kept getting more and more bad news. I had to take over everything with the house and property, as well as drive over 100 miles back and forth from the hospital everyday. Sometimes it was 3:00 in the morning when I would drive home. I was going without sleep, eating fast food, and my exercise routine was trashed. I appeared calm and collected and in control of everything, but I guess my body reacted in its own way. That is when my sugar started climbing. I called the endocrinologist and he sent me to the hospital for testing. He did not think I needed any medicine. One of the nurses in his office told me that he was shocked when my blood work came back at 400. The office called and said that I needed to go on Lantus. My husband is now doing much better and I am starting to let go of the tension and fear. All of my doctors assure me that they are going to take care of things. They tell me that I have to give myself time and let my body heal. I am working with the doctors and we have a plan to get things back to normal. My endocrinologist says his biggest worry now is that I will go too low too quickly. He is increasing my medicine 1/2 pill every few weeks until we come up with the right combinination to stay in control. I guess what I have learned from this, is that extreme stress can bring on diabetes, even after gastric bypass.
   — Mary Catherine

November 25, 2008
Mary, I just read your last response and I just wanted to send you a giant bear hug! You poor thing! You didn't mention stress in your first post! Stress can make even the most solid person crumble! What you went thru is more than most could handle without medical issues!! I'm so glad hubby is doing better...I hope you both have better days to come! It's so hard to take care of yourself when your only thought is someone else! Sending you and your family healing wishes!
   — .Anita R.

November 25, 2008
Mary ... it's your genes, honey. I was diagnosed with Type II diabetes when I weighed almost 350 pounds, before my surgery in April 2000 -- when I lost the weight, the diabetes went away -- for six years. It "returned" in April 2006, when it was re-diagnosed, and it's been my close friend and travelling companion since. My father and paternal grandmother were both diabetic, I was a severe gestational diabetic when I was pregnant with my first son, and I had two babies weighing more than ten pounds -- so I got the craptastic end of the stick as well. And your family history of diabetes is much stronger -- so it shouldn't be much of a surprise. As others have posted, I would ask to be referred to an endocrinologist who specializes in diabetes -- and if s/he happens to know about diabetes and WLS, bonus, bonus, bonus! I was quite disappointed when my diabetes recurred, but, as your doctor has pointed out, not everyone can escape their genes. For many of those who have WLS and are subsequently "cured" of their diabetes, I would venture that it was purely a function of excess body fat and not genes, like the cases of polycystic ovarian syndrome in many overweight women -- although THAT doesn't always go away, either. Don't be discouraged -- the way I look at it, there's lots worse things that could happen. Get an appointment with an endocrinologist and get your sugars under control, and then just go on with your life. As well, you might talk with the nutritionist at the hospital where you had your surgery -- they often have good ideas, or get an appointment with a diabetes nurse educator -- I got a lot of support and help from them when I was pregnant, and when the diabetes "came back". Best of luck, and blessings always --
   — Cheryl Denomy