Diabetes

[jjoyce282 23]

Hey everyone!

Just curious as to how many of you had type 2 diabetes before your sleeve and did the sleeve CURE your diabetes and if so how long did it take? My dad is considering having the sleeve as well but had heard that the RNY was better at curing diabetes....any input would be great!

[mrchris 98]

RNY or the DS statistically are a little better. I "had" type 2 diabetes for roughly 10 years prior to the sleeve. Well controlled with Metformin and Byetta (no insulin). I stopped all diabetes meds the day before surgery and haven't needed them since. Surgery date was Nov 15th so I'm nearly 3 months out. Diabetes is gone, typical fasting glucose is around 90 and after a meal I might hit as high as 160. While not perfect it's well within "normal" though I wouldn't mind seeing the fasting glucose closer to 75. Cured my hypertension too. Only prescriptions I am on now are for B12 injections and 50,000 iu's of Vitamin D. It's been exceedingly effective for me.

[enigmachik 403]

The reason that the RNY has better statistics on diabetes is because with RNY most people HAVE to limit carbs and sugar or they get dumping syndrome. With the sleeve, you should restrict your sugar, but not everyone does because many people have no problem at all with it tolerating it after the sleeve.

That being said, the sleeve cured my diabetes. Mine was controlled using Metformin before surgery, but now I'm completely off all meds and my blood sugar is well within the normal range!!

[Texas14 16]

I was sleeved 01/28/2013. 11 days 30lbs off and no insulin anymore!!! Just taking onglyza, but eventually I will not need it.

[TakeCareGirl 161]

I had Type 2 diabetes for about 8 years. VSG on 9.25.12 - my blood sugar improved immediately - I was almost immediately off one of my meds glucophage, and as of last weekend I am off of the last one - metformin, as well as my high blood pressure medicine. So for me about 4.5 months. I'm very happy and feeling awesome about my improved health.

Good luck to your father!

[jjoyce282 23]

Thank you all for the information! My father is currently on two different insulins and two different oral meds for diabetes. Like I said, he is trying to decide VSG vs RNY....he will be paying out of pocket for his surgery so he, of course, wants to make the best decision and only do the surgery once! I think this info will help solidify his decision for the VSG....it may be slower (around 3-4 months) before he is off all of his medications but VSG is significantly cheaper when paying out of pocket too!

Thanks again!!!

[RickM 1,747]

None of the procedures really "cures" the diabetes, but they can knock it into remission; if you regain the weight, there is a good chance that the diabetes will follow it.

When my wife and I started looking at WLS almost ten years ago, it was thought that the intestinal rerouting done in the RNY and DS was responsible for the metabolic changes that drove the diabetes into remission; since then, as the sleeve has become more popular as a stand alone procedure, it has been found that it, too, has a metabolic influence on diabetes and many leave the hospital without need of meds or insulin, so it isn't strictly a function of the weightloss as previously thought, and the remission rate for the sleeve is similar to that of the RNY, typically in the 80-85% range. If treating diabetes is ones' primary concern, then one should look seriously at the DS as well as that procedure has a diabetes remission rate of around 98%. This should not come as a surprise as the DS started as an intestinal rerouting procedure targeting diabetes to which the sleeve was added to make it a weight loss procedure as well. The DS is a longer and more technically challenging procedure for the surgeon which is why many don't offer it (but those that do tend to be from the top of the class, so those are guys who are well worth investigating no matter which procedure one chooses.) It will also usually be the more expensive procedure, but its also the most powerful in terms of weight loss and regain resistance. I was talking to a woman at our support group a few months ago who had an RNY 25 years ago and by all measures has been very successful with it, maintaining her normal weight range - up until just a few years ago when some of life's stresses brought back some of her long lose weight (not the 100+% regain we sometimes read of, but maybe 50-60%) and with it her long lost diabetes. Her weight is not overly excessive (at least these days in the western world!) but it is the diabetes that has her concerned, so she is pursuing a revision to the DS to knock it out.

Deciding on what WLS procedure to pursue is not easy - for me starting as a relative lightweight with around 100lb to lose and reasonable dietary discipline developed over these past few years of working to avoid WLS (but no diabetes,) the VSG was the choice for me; for my wife with her diabetes and 200+ to lose, the DS was the better choice, and she still maintains after eight years that she could not have been successful with just the VSG (or the RNY.) A great presentation on the different characters of WLS procedures is here -

http://www.obesityhelp.com/forums/amos/4416773/quotDoes-the-Patient-Fail-the-Procedure-or-Does-the/action,replies/topic_id,4416773/page,1/

I fully understand the cost concerns, and the interest in only going through this once. We self paid for my wife's DS and it was definitely the way to go for us. Some at a similar starting point can get by with the RNY or VSG, but it takes a somewhat different character to do so. In the close to ten years that I have been in this world (only the past 20 months or so on my VSG,) we have seen a few three time WLS patients - band revised to RNY revised to DS to get what they needed, so it is well worth the time to research the heck out of this to get the best fit for your needs.

One final bit of perspective on my VSG and why the RNY was never a serious consideration for us (beyond the basic differences that are usually brought out in threads about the RNY vs. VSG like no NSAID use, possible dumping, and misc. nutritional issue after the RNY,) is that should the RNY fail us and needs revising to something else like the DS, that is a very complex revision for which only a very few surgeons (on the order of a half dozen in North America) are qualified to do, while the VSG is an integral part of the DS so a future revision is fairly straightforward should it be necessary.

Good luck on something that is not an easy decision,

[ebonisekim 1,713]

Thank you all for the information! My father is currently on two different insulins and two different oral meds for diabetes. Like I said' date=' he is trying to decide VSG vs RNY....he will be paying out of pocket for his surgery so he, of course, wants to make the best decision and only do the surgery once! I think this info will help solidify his decision for the VSG....it may be slower (around 3-4 months) before he is off all of his medications but VSG is significantly cheaper when paying out of pocket too!

Thanks again!!![/quote']

Your dad has to look at how much weight he want to lose his medical history and much more to determine the wls he wants to go with as well

[jjoyce282 23]

Agreed! We all went to an information session about our surgeon and the program he offers. My husband and I had already made up our minds that we wanted the VSG. However my dad wasn't really sure...after the info session he, too, decided on the VSG. He met with our surgeons Nurse Practitioner the other day and she said that she would recommend the RNY over the VSG for him because it would totally cure his Diabetes instead of just improving it. This threw a wrench into things bc after that he wasn't so sure! I told him that either one could assist him with getting rid of his diabetes, one just may take a little longer than the other! It's a personal choice that only he can make!

[misslady 130]

The surgeon perfoming my surgery told me (I am diabetic about 3 yrs on Metformin) that if I had been diabetic alonger period of time or was on insulin or had poorly controlled diabetes on oral meds he would recommend the RNY for "curing" the diabetes. But since that is not my case the VSG would take care of it. I know this is such a life changing decison and it is not easy.

[nyc8dove 40]

im soooo looking forward to stopping the medication.