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Warning to my fellow Diabetic Sleevers



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I just wanted to warn people and hopefully save some one from going through what I went through. I have been a diabetic for 20 yrs insulin dep on an insulin pump. I was sleeved on 3/10/14. I was d/c from hospital with out any insulin or medications for diabetes feeling great, like I never has surgery . My blood sugars were good for a week or so, but shortly after they started to rise into the 300 as I suspected it would. My endocrinologist wanted to treat this with oral meds rather than resort back to insulin. She tried to prescribe me metformin, I refused to take it as its #1 side affect is diarrhea and non of us need extra help in that area! So next she wanted to prescribe Juanovia which should not be taken by anyone who has or has a history or gallstones {which I do} so that was out. Next up she prescribed me a new medication called INVOKANA. I started to take it on Tuesday by Wed I was urinating like crazy , like every hour kind of crazy and diarrhea . Thursday still urinating feeling very tired and began with a funny feeling in my stomach. Thursday night I was feeling short of breath. Friday morning I barely woke up, feeling very lethargic , still peeing like a race horse, short of breath, vomiting. I was taken to the ER and was admitted .After spending 7 days in the hospital and umpteen blood, urine and any other tests they could think of later I was diagnosed with DKA = Diabetic ketone acidosis, Doctor said had I not come in when I did I probably would not have woken up the next morning. Cause of the DKA = INVOKANA. Apparently #1 side affect is sever dehydration, frequent urination and pretty much shuts down your kidneys and makes you spill sugar into your blood causing your body to produce extreme amounts of toxic poison's and acids causing your organs to shut down. DKA when not treated immediately can cause coma, brain swelling, damage and worst death. I was lucky... So please be hyper vigilant when your doctor orders something , look into it first. Don't just trust that she's a doctor and she knows everything and don't worry about looking stupid ask questions. Doctors are human they make mistakes, but because of her mistake my 3 yr old son was almost left motherless. I hope this helps , even if only 1 person. Good luck on your new journey everyone. Rose

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Rose, my husband has been diabetic over 30 years and was sleeved 12/2/13. I simply cannot believe you were taken off insulin. I think you have a nut for an Endocrinologist and I sure would find another one fast. My husband's insulin dosage has been lowered by his Internist, following the sleeve. You must be proactive when it comes to your diabetes, and I have read many posts here where diabetics discuss they are still on insulin following their surgery. I had been on Metformin a year, and following surgery I was taken off the Metformin. But insulin is a different matter. I cannot imagine this doctor thinking you would not need insulin, and sounds like you had a doctor who did not know what she was doing. We asked many questions prior to surgery, and we had our answers. One of the nurses who ran our program said 5 years after the sleeve she is still on insulin and will never come off. So we have the knowledge that my husband may be on insulin the rest of his life, but the good part is that he no longer has to eat carbs at bedtime to keep him conscious through the night. You are very lucky to be alive, in my humble opinion. Let this be a lesson in life for you that doctors are not perfect and you are in charge. I cannot believe all this happened to you and I hope everything gets under control. God Bless you!

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Rose, my husband has been diabetic over 30 years and was sleeved 12/2/13. I simply cannot believe you were taken off insulin. I think you have a nut for an Endocrinologist and I sure would find another one fast. My husband's insulin dosage has been lowered by his Internist, following the sleeve. You must be proactive when it comes to your diabetes, and I have read many posts here where diabetics discuss they are still on insulin following their surgery. I had been on Metformin a year, and following surgery I was taken off the Metformin. But insulin is a different matter. I cannot imagine this doctor thinking you would not need insulin, and sounds like you had a doctor who did not know what she was doing. We asked many questions prior to surgery, and we had our answers. One of the nurses who ran our program said 5 years after the sleeve she is still on insulin and will never come off. So we have the knowledge that my husband may be on insulin the rest of his life, but the good part is that he no longer has to eat carbs at bedtime to keep him conscious through the night. You are very lucky to be alive, in my humble opinion. Let this be a lesson in life for you that doctors are not perfect and you are in charge. I cannot believe all this happened to you and I hope everything gets under control. God Bless you!

Linda,

Hello... I was browsing around and was so glad to see this post. I am not sure if I mentioned this before (when we have talked) I am a diabetic on insulin. In November 2012, I had been rushed to the hospital for DKA and was in diabetic shock... I was literally out of it for 3 days *which i am still unable to recall*. Doctors told my husband at that time that my sugars were so high they were literally off the charts and I was lucky to be alive. When the #s finally started to register it was 815. Long story short, I truly thank God I am here. Anyway, the reason I told that is to lead to the following. With that episode happening, my previous endocrinologist thought perhaps I was type 1 diabetic, (instead of type 2,as previously diagnosed in 2003) they ran the specific tests and I was told that I was not type 1, but definitely type 2. Time went on and I am no longer seeing that doctor and now have a new endocrinologist.... and well seeing my history on record and blood sugar issues, he also wanted to test me to see if I was type 1. Longer story short, at my last visit I was told that the blood tests confirm that I am type 2 but I also have traits of type 1 diabetes... which makes my case of diabetes different....

He further told me to inform Dr. Uchal that more than likely i have impairment going on with my pancreas (which of course is nothing new as diabetes effects the pancreas) but he then told me that with my upcoming bariatric surgery, not to expect to be off of my insulin completely... (which didn't shock me, as I know how the slightest intake can make my sugar go up).

I say that full, long story for this reason... in finding out the recent info, I started to worry about the "what if's" again... thinking what if this surgery will not work because I am remaining on insulin (as insulin can cause weight gain). It truly started to upset me so much to where it prompted me to search for info on this site... (that is how I found the above post and your reply) May I ask, "has the insulin hindered any of your husband's progress/weight loss?" I am trying not to worry but I want to be prepared. I told my husband my fear would be that I do the surgery and that the insulin sabotaging my results, especially since I have a lot of weight to lose....

(my apologies for the lengthy story...lol... but any reply would be helpful..)

Sincerely, Angi

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Angi, my husband has gone from 320 to 250 since approximately October, 2013. He was sleeved Dec. 2. Definitely the diabetes has not hindered his weight loss. My husband is off Metformin from the day of the sleeve, and he dropped from 100 units to 35 units of long acting insulin (and no short acting anymore) in the evening. His A1C went from 12 to 6.7 (excellent). We were absolutely terrified for my husband to even have the WLS because of his health problems, and had been attending seminars about 10 years. He dieted his entire life and has always been overweight. He is so much healthier, and I know in my heart he will never regain this weight. He usually eats about one meal a day, and barely ever any carbs or fruit any more. That is his choice. The greatest thing is he said he has always been hungry his whole life, and he does not have the cravings he once had. I could not find much on diabetes and the sleeve prior to surgery, just a few things word of mouth. When my husband had a heart blockage 10 years ago, his blood sugar was 500, so I can only imagine how sick you were. I am just very thankful we had the courage (I led my husband through it because of my fear I would lose him) and today he is glad he did it. Every day prior to surgery it seemed as if we were going downhill, but no more! What can I do to help you? We are 67. We are feeling fabulous. What will your health be like if you do not have the sleeve? This was our dilemma, after spending the past year of my retirement in recliners and deciding we were not ready to give up. Hugs, Linda

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Angi, my husband has gone from 320 to 250 since approximately October, 2013. He was sleeved Dec. 2. Definitely the diabetes has not hindered his weight loss. My husband is off Metformin from the day of the sleeve, and he dropped from 100 units to 35 units of long acting insulin (and no short acting anymore) in the evening. His A1C went from 12 to 6.7 (excellent). We were absolutely terrified for my husband to even have the WLS because of his health problems, and had been attending seminars about 10 years. He dieted his entire life and has always been overweight. He is so much healthier, and I know in my heart he will never regain this weight. He usually eats about one meal a day, and barely ever any carbs or fruit any more. That is his choice. The greatest thing is he said he has always been hungry his whole life, and he does not have the cravings he once had. I could not find much on diabetes and the sleeve prior to surgery, just a few things word of mouth. When my husband had a heart blockage 10 years ago, his blood sugar was 500, so I can only imagine how sick you were. I am just very thankful we had the courage (I led my husband through it because of my fear I would lose him) and today he is glad he did it. Every day prior to surgery it seemed as if we were going downhill, but no more! What can I do to help you? We are 67. We are feeling fabulous. What will your health be like if you do not have the sleeve? This was our dilemma, after spending the past year of my retirement in recliners and deciding we were not ready to give up. Hugs, Linda

Hello Linda,

I cannot begin to express just how much this email encouraged me! This helped me so very much. As I previously mentioned I have been excited and counting down to my surgery, which hopefully will be in July *depending on how fast the insurance stuff goes through*. The recent bump in the road was my recent findings regarding my type 2 diabetes also having traits of type 1... that truly got me fearing that it may interfere.... Hearing your story truly helped, I have many different health issues along with diabetes.... I am currently on 55units of long acting insulin twice a day, and my meal-time insulin is 30-35 units, with also using the sliding scale if/as needed. I have been on and off of metformin... *recently weened off of it as I have been having a lot of stomach issues and various doctor appointments that it would effect (by creating difficulty) Now on tuesday, I will be at st.vincents riverside for the removal of the left lobe of my thyroid as it is enlarged and concerning, so I have kept off the metformin for that too.

I am so happy to hear your and your husband's progress on your journey and I truly look forward to my days ahead.... I am truly doing this for my health, as I know that if I did not make this decision my health and life would suffer severely.

Hope you have a great week. I will talk to you soon.

Sincerely,

Angi

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Angi, my husband has gone from 320 to 250 since approximately October, 2013. He was sleeved Dec. 2. Definitely the diabetes has not hindered his weight loss. My husband is off Metformin from the day of the sleeve, and he dropped from 100 units to 35 units of long acting insulin (and no short acting anymore) in the evening. His A1C went from 12 to 6.7 (excellent). We were absolutely terrified for my husband to even have the WLS because of his health problems, and had been attending seminars about 10 years. He dieted his entire life and has always been overweight. He is so much healthier, and I know in my heart he will never regain this weight. He usually eats about one meal a day, and barely ever any carbs or fruit any more. That is his choice. The greatest thing is he said he has always been hungry his whole life, and he does not have the cravings he once had. I could not find much on diabetes and the sleeve prior to surgery, just a few things word of mouth. When my husband had a heart blockage 10 years ago, his blood sugar was 500, so I can only imagine how sick you were. I am just very thankful we had the courage (I led my husband through it because of my fear I would lose him) and today he is glad he did it. Every day prior to surgery it seemed as if we were going downhill, but no more! What can I do to help you? We are 67. We are feeling fabulous. What will your health be like if you do not have the sleeve? This was our dilemma, after spending the past year of my retirement in recliners and deciding we were not ready to give up. Hugs, Linda

Hello Linda,

I cannot begin to express just how much this email encouraged me! This helped me so very much. As I previously mentioned I have been excited and counting down to my surgery, which hopefully will be in July *depending on how fast the insurance stuff goes through*. The recent bump in the road was my recent findings regarding my type 2 diabetes also having traits of type 1... that truly got me fearing that it may interfere.... Hearing your story truly helped, I have many different health issues along with diabetes.... I am currently on 55units of long acting insulin twice a day, and my meal-time insulin is 30-35 units, with also using the sliding scale if/as needed. I have been on and off of metformin... *recently weened off of it as I have been having a lot of stomach issues and various doctor appointments that it would effect (by creating difficulty) Now on tuesday, I will be at st.vincents riverside for the removal of the left lobe of my thyroid as it is enlarged and concerning, so I have kept off the metformin for that too.

I am so happy to hear your and your husband's progress on your journey and I truly look forward to my days ahead.... I am truly doing this for my health, as I know that if I did not make this decision my health and life would suffer severely.

Hope you have a great week. I will talk to you soon.

Sincerely,

Angi

Private message me and when you feel up to it please call or we can meet for lunch before you have the sleeve in July. God be with you during this surgery. I am glad you are taking positive steps in your life. We are very thankful we finally got the courage for the WLS. I hope it will profoundly change your life. Linda (you hang in there Angi!)

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Rose, my husband has been diabetic over 30 years and was sleeved 12/2/13. I simply cannot believe you were taken off insulin. I think you have a nut for an Endocrinologist and I sure would find another one fast. My husband's insulin dosage has been lowered by his Internist, following the sleeve. You must be proactive when it comes to your diabetes, and I have read many posts here where diabetics discuss they are still on insulin following their surgery. I had been on Metformin a year, and following surgery I was taken off the Metformin. But insulin is a different matter. I cannot imagine this doctor thinking you would not need insulin, and sounds like you had a doctor who did not know what she was doing. We asked many questions prior to surgery, and we had our answers. One of the nurses who ran our program said 5 years after the sleeve she is still on insulin and will never come off. So we have the knowledge that my husband may be on insulin the rest of his life, but the good part is that he no longer has to eat carbs at bedtime to keep him conscious through the night. You are very lucky to be alive, in my humble opinion. Let this be a lesson in life for you that doctors are not perfect and you are in charge. I cannot believe all this happened to you and I hope everything gets under control. God Bless you!

Linda,

Hello... I was browsing around and was so glad to see this post. I am not sure if I mentioned this before (when we have talked) I am a diabetic on insulin. In November 2012, I had been rushed to the hospital for DKA and was in diabetic shock... I was literally out of it for 3 days *which i am still unable to recall*. Doctors told my husband at that time that my sugars were so high they were literally off the charts and I was lucky to be alive. When the #s finally started to register it was 815. Long story short, I truly thank God I am here. Anyway, the reason I told that is to lead to the following. With that episode happening, my previous endocrinologist thought perhaps I was type 1 diabetic, (instead of type 2,as previously diagnosed in 2003) they ran the specific tests and I was told that I was not type 1, but definitely type 2. Time went on and I am no longer seeing that doctor and now have a new endocrinologist.... and well seeing my history on record and blood sugar issues, he also wanted to test me to see if I was type 1. Longer story short, at my last visit I was told that the blood tests confirm that I am type 2 but I also have traits of type 1 diabetes... which makes my case of diabetes different....

He further told me to inform Dr. Uchal that more than likely i have impairment going on with my pancreas (which of course is nothing new as diabetes effects the pancreas) but he then told me that with my upcoming bariatric surgery, not to expect to be off of my insulin completely... (which didn't shock me, as I know how the slightest intake can make my sugar go up).

I say that full, long story for this reason... in finding out the recent info, I started to worry about the "what if's" again... thinking what if this surgery will not work because I am remaining on insulin (as insulin can cause weight gain). It truly started to upset me so much to where it prompted me to search for info on this site... (that is how I found the above post and your reply) May I ask, "has the insulin hindered any of your husband's progress/weight loss?" I am trying not to worry but I want to be prepared. I told my husband my fear would be that I do the surgery and that the insulin sabotaging my results, especially since I have a lot of weight to lose....

(my apologies for the lengthy story...lol... but any reply would be helpful..)

Sincerely, Angi

Angi, Sounds like you have type 1.5. Certainly sounds like it. (You can google it! ) :)

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Rose--

I am assuming since you were taken off insulin after surgery that you were diagnosed as a Type II? Has this been tested? It sounds like if it took the hospital multiple tests to figure out a diabetic is in Ketoacidosis, something is seriously wrong with that medical establishment. I hope you are better now!

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Rose--

I am assuming since you were taken off insulin after surgery that you were diagnosed as a Type II? Has this been tested? It sounds like if it took the hospital multiple tests to figure out a diabetic is in Ketoacidosis, something is seriously wrong with that medical establishment. I hope you are better now!

Hi, yes I was diagnosed as a type 2, they did know quickly about the dka but there were other issues present as well,i was severely dehydrated and other affects from the medication. They were questioning whether I was type 1 because it is very uncommon for a type 2 to develop dka. I have since seen a New endocrinologist and was tested to see if I'm type 1 or 2. He stated that being on insulin for 10 plus yrs then stopping all at once with out being tappered off is probably set everything in motion, top it off with the dehydration caused by the oral meds. The hospital I was at did a good job and was very thorough with everything I can't complain about them. Thank fully I have been doing well and back on track still on insulin but I'm ok with that. Thank you, good luck on your journey.

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Happy to hear you are OK and the hospital/doctors know their stuff after all. As as a type 1, I have found the need to drastically taper my insulin. I am on a pump too, and if II bolus, it is rare. (And usually a mistake, as I tend to tank after doing so. ) I am still trying to balance the need to treat lows with carbs while needing to keep my carbs low for weight loss. It slowed things down significantly this week. Hopefully it will all figure itself out!

Best of luck to you too! :)

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I have nothing valuable to add to this thread, but I am SO GLAD to be reading ANYTHING here by people with T1. Thanks for sharing your experiences.

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Hello, I was sleeved 7/12/12. Type 2 was on a pump and on 120+ units daily give or take a few . Now on 18 units Levemir and humalog boluses as needed if too high before meals or sick days. I had hoped to be off insulin but apparently my pancreas is kaput so I have very little endogenous insulin. Yes, we have to be diligent and proactive when dealing with diabetes . It pays off when you think about avoiding the dire and deadly consequences of this insidious disease. All the best to you my fellow diabetic sleevers! I see my endocrinologist on Thursday . We shall see if A1C is acceptable ...

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My husband is down 110 lbs and still on the low dose insulin, but no more sleepless nights worrying that he will die from low blood sugar and no more calls for rescue and glucagon shots to revive him. We are both still off Metformin, but our A1C has climbed since the drop after surgery, not sure why. We accept what is is and would do this again 1000 times over!!!!

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I am a T1 diabetic and just got sleeved on August 14th. I lost about 30 pounds in approximately 3 1/2 months before my surgery and reduced my insulin quite a bit, from 50 to 40 units of lantus and from 50-60 down to about 20 of humalog a day. Since my surgery, I have again decreased my lantus down to 20 units and my humalog down to about 5 units a day. The insulin will never go away for me, but I'm so glad to already be reducing my needs only 3 days post-op. I feel like I had success before with losing thru diet and exercise, and I am confident that the surgery will just continue to lose successfully.

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So glad I came across this post. I'm sorry that your endocrinologist was not helpful in your care. I am a type-1, 100% non-functioning pancreas, and on an insulin pump. I have had my share of not-so-great endo's. I have been diagnosed and hospitalized with DKA too many times to count(I'm talking several times a year for the past 16 years) until they could somewhat stabilize me. I have slight diabetic retinopathy in the eyes(fortunately it doesn't affect my vision as of yet) and kidney damage. I have gone to the er unconscious via ambulance with a blood glucose over 1000(docs said I shouldn't have been alive) and been in 2 diabetic comas. I have now found and been with a wonderful endo who recommended the sleeve as I have gained quite a bit of weight while stabilizing my levels. I know I will never be free of insulin, but am hoping that I can lose some of the excess weight while bringing my A1C to an acceptable level. Any insights from type-1 peeps out there would be greatly appreciated!!!!

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