Question:
Type I&II diabetic poor control, poor pcp, what can i do?

Hi all, I have had type I diabetes for 15 years (since I was 10) and recently (the past 2 years) the docs have been feeling I have type II also. I have always taken huge amounts of insulin 100+ total units per day. I recently moved to a small fairly remote area where docs don't seem to have much experience with this. I've only seen my pcp here once and so far all she's done drop my control even further although she isn't against the surgery, just not very pro-active. I am fairly sure I want the surgery, however I'm not sure how I should go about it. I have gotten no recommendations on good diabetic docs in the area and am wondering if I should just try and contact the surgeon's office directly and see if they can help me. Or should I just try to wade through until I can find a good pcp who can get me in control? Any ideas? Has anyone had the surgery who has type I along with insulin resistance?    — Karen H. (posted on November 29, 2001)

November 29, 2001
Your best bet with this issue is to go to an Endocrinologist.They are the experts in this field and you will most likely get the best care for any type of diabetes. Good Luck..
   — garyzgurl

November 29, 2001
Type one morbidly obese, your very rare according to my surgeon? Now its more likely your a type 2 becoming type one. Years of being a type 2 can burn out the pancreas and lead to type one diabetes where your body quits producing insulin altogether. In any case I would first contact a surgeon, he will then as part of pre op test refer you to a endcrolongist or other doctor to get your diabetes under control. This doctor will work closely with your surgeon to get you in the best shape possible. 85% of type 2 diabetics are cured by the surgery, off insulin and pills with normal sugars all the time, although they may carry the diabetic label forever. WLS is approved by the NIH as a treatment for diabetes in the morbidly obese. I am a type 2 since 1985 of ALL precription drugs since about a month or so after surgery. Even if your a tpe one loosing the weight will decrease the amount of insulin needed, and make control a lot better. Support group meetings are full of these results, attend your local one. Good luck your on the way to a new healthier life....
   — bob-haller

November 30, 2001
Karen, I'm one of the co-hosts on an internet support group for diabetics at www.Worldcrossings.com and extending to you and anyone else here a personal invitation to stop by, vist and post. My co-host and I worked at the now defunct PlanterRx.com and for awhile with Diabet4esInterview.com and know tons about diabetes, the latest trends, where to go for the right answers and can really help to get you back in control. We follow the standards of the American Diabetes Association, and the other international organizations that set the standards. We've had the wonderful opportunity to get involved with diabetics around the world, and have truely found that no matter how remote you may think you are, and how lacking good care can be, it isn't! Please stop by and if only to read about my success and how I've been off of my meds for 3 months now! As to getting in control before seeing a surgeon, I would definately do so! My personal experience has been that my surgeon answered all of my pre-op diabetes questions correctly, but in the hospital and post-op he became very evasive about things and bounce me back to my PCP for "those questions". Last week, after 3 months of having my surgeon and PCP be at opposite ends of the long term post-op diabetes care issue, I decided that I would not return to see the surgeon unless it was an emergency directly related to my WLS. Before having surgery I talked with a psyc specializing in eating disorders and patients who have bad outcomes with WLS----her take was that yes, WLS can help diabetes, but only if you have the porper attitude about it before and after. And that is, that WLS is just another tool like diet, medication, exercise, and insulin to help keep diabetes in control so that complications are delayed. Remember that even if you are not on medicaitons, like me, you will always be a diabetic and at risk for complications, you are just delaying and avoiding them by keeping your blood glucose levels in the normal ranges.
   — Sue F.