Question:
Stay on oral meds or switch to insulin pre-op

Hi, I'm scheduled for surgery July 28th. I'm a diabetic controlled with 3 meds. I met with the nutritionist yesterday and we talked about possibly going on insulin to manage my diabetes. She said that because I would have to be adjusting my meds so frequently as I start to lose weight that using insulin with a sliding scale would be easier to adjust and wean off. I go to see an Endocrinologist for the first time May 14th so I'll talk with him. I was wondering if anyone did this or has any advice regarding this issue. Thanks, Beth    — Beth E. (posted on May 6, 2003)

May 6, 2003
Many people with Type 2 diabetes are able to discontinue their meds soon after surgery. Please be very clear that WLS does NOT cure diabetes. There is no cure, but you will be able to control it with diet and exercise. I'd put a lot more faith in the endocrinologist to help you manage your blood sugars than in a dietician, unless she is a certified diabetes educator. If your control is good with the meds you're using now, I'm not sure I'd change. One thing that is really important is making sure your blood sugars are as close to normal as possible. This is because high blood sugars, not diabetes in and of itself, are the cause of poor healing. I think it would be wise to just hold off making any decisions until you see the endo.
   — garw

May 6, 2003
I am 7 weeks post op and I too have type II diabetes and was taking 3 meds twice a day with good control prior to surgery. During the time I was in the hospital my blood glucose was pretty good and did not require medication. When I was discharged my blood glucose averaged 100-120 and so I did not take any of my meds. Since then my internest put me back on Glucophage, stating since I have a propensity for diabetes it would be wise to continue but at half the dose. I was taking a total of 1 gm twice a day and now take 500mg twice a day. I no longer take glyburide or Avandia because I become hypoglycemic. Glucophage helps me utilize the glucose in my blood stream and protects me should my glucose level becomes elevated. Say following a meal. I once had a monthly pharmacy bill of $190.00 for 8 different medications with an HMO copayment. Now my pharmacy bill its $30. You are going to love it! I would definately do what your Endocrinologist recommends. Good luck!
   — Rebecca L.

May 6, 2003
I am 3 months pre-op, and I am a type II diabetic. I have been taking insulin and oral meds for 11 years now. Just recently I had to be taken off of alot of meds because I had a enlarged liver, and was taken off of the oral diabetes meds, and put on the sliding scale of insulin only. It is so much better control, and the oral meds make you swell, but remember, the docs do not tell you that using insulin can help in the weight Gain. So be sure they give you a diet because you will gain weight. I do not care how much insulin I have to use to keep my numbers low, in just 3 months, hopefully I will not need any insulin. Hope this helps
   — cindy