Hi everyone,

:help:I need an eating plan appropriate for a bandster who is a diabetic. Does anyone know where I could locate one? Or should I contact a dietitian to develop one?

I've tried figuring this out myself. I think a structured eating plan would help, but I get totally overwhelmed trying to integrate what I should eat for various conditions I have. Think I need high-Protein, low-carb, healthy fat, low-sodium, etc. Aaargh!

I am really discouraged. Banded 5 months ago and fills just reached sweet spot 2 weeks ago. When I got banded, I thought it would reduce my hunger and stomach volume so that I'd automatically lose weight. Ho ho. I'm actually gaining weight because I'm eating poorly (ice cream, chocolate, etc.) And I'm beating myself up psychologically, too: "How could you go through all that workup and the surgery and now sabotage yourself?? You must be a bad person."

I feel totally overwhelmed right now by all the changes I need to make in the way I eat and exercise and treat myself!

Hi Nancy,

I was banded 6 weeks ago and go for my first fill tomorrow. Yippee, because I have been feeling like you - can eat what and how much I want and not making the best choices. I lost 25 lbs preop and have put back about 7 so far. Hoping this fill tomorrow will help.

I am also diabetic. You didn't say if you are on meds/insulin but in either case the best thing is the typical bandster diet. Eat your Protein first, followed by complex low glycemic carbs i.e. veggies and fruit and then if there is room, a small amount of good starch i.e. grains, sweet potatoes, brown rice if you can eat it, whole wheat Pasta etc.

The problem with stuff like chocolate and ice cream; simple carbs/sugars - especially for us is that not only do they raise our glucose levels very quickly, which in turn makes us hungrier!!!, they are also very addicitive.

For me, the best way to do this is go off simple sugars completely for a week. Usually after 3-4 days, I feel better and don't feel the urge to eat that stuff as much, by a week I am not feeling the pull of it at all. Your blood sugars will be great, just remember to monitor often for lows because this is likely when you hve been consuming alot of sugar and then go off. I take a basal dose of insulin once each evening and then carb count for my meals to take the rapid insulin required to cover what I am eating. It is more work, but definitely worth the tight control I get.

Let me know what you think and feel free to pm me any time.

Good luck!

Susan,

Thanks so much for your advice, especially on how to get off chocolate and simple sugars -- I am definitely addicted. I'm on insulin--Levemir at bedtime, Novolog for sliding scale. Also thanks for the heads-up about hypoglycemia as I wean myself off sweets.

It took me 3 fills to reach the "sweet spot" where the band significantly limits my intake. Here are some words of advice.

Failing to chew thoroughly (like 35 times) or to take small bites definitely triggers PB'ing, which feels horrible. The first time it happened, I'd been talking animatedly with a friend over Breakfast and was too absorbed to pay attention. I took a normal bite and swallowed it -- instant severe chest pain!

I quickly muttered "Excuse me -- I'm suddenly feeling nauseated." I took off for the rest room with my napkin clutched in my hand -- a good thing, too, because I upchucked on the way to the bathroom. I've had several episodes since then, suspect it's common while we learn new eating habits.

I know I'm not supposed to, but I've actually stuck my finger down my throat when food is stuck -- that's how much it hurts. Once I burp, I feel much better. Now I cut my food into teeny pieces as soon as it's served.

I came across some great tips about getting fills. I'll try to track them down for you. The only one I remember now is to be sure you're well hydrated the day before and drink a couple of glasses of Fluid before you go for the fill.

Take care,

Nancy+

Thanks Nancy, I appreciate the tips! The weird thing is, and maybe it's because I am nervous about tomorrow, is that I have been feeling someehat restricted all day. We had a family BBQ for lunch and could not finish my hambuger - ate about 1/3, Then dinner was a take out roast chicken dinner and could not finish that either! Weird, but I hope it is a preview of what will happen for me.

Looks like we are on the same insulin regimen. I take levemir as well, but my fast acting is novorapid. Has you doctor indicated that you might come off insulin with weight loss? I have been diabetic for 25 years, so I doubt that will happen in my case, but I am hoping to go off blood pressure meds at least. We will see.

My certified diabetic educator, herself a diabetic, works for an endocrinologist. He said it's unlikely I'll be able to come off insulin completely, but we should be able to cut the dose way down. My surgeon said he had one patient who was on both insulin and an oral hypoglycemic who came completely off everything 3 days after surgery!! He was stunned. I used to be on Lantus, and postop I got down to 1/3 of my preop dose.

Wow, great information. Thanks for posting it. If you can get hold of the article, please fax it to me at 925-254-0461 or send it to Nancy Holloway, 5 del Valle, Orinda, CA 94563. I plan to share it with my surgeon, diabetes educator, endocrinologist, and dietitian, too -- might as well update everybody! Your prompt, caring response is one of the reasons I love this board.

Nancy

I developed diabetes AFTER an 80 pound weight loss following surgery (which has baffled pretty much everyone), I have about 25-30 pounds left to lose. It doesn't run in my family, I never had it before my surgery. Years of morbid obesity just caught up with me I guess. I'm at a good level of restriction and I follow my diabetic educator's plan. I take Metformin 4 x a day and Lantus long-acting insulin at bed only. My sugars are well under control now. I don't eat many carbs though, at the most 15 grams per meal with 2 15 gram snacks a day as well. I can't handle any more carb than that, my sugars go up. Obviously I don't eat anything white anymore and I never eat any kind of bread (it always get stuck). I would say to follow what your endocrinologist/diabetic dietician has to say about your diet, having the band doesn't make it too difficult in my opinion, it just makes managing diabetes easier since your portion sizes are so limited. Good luck.

I just logged on for the first time and this caught my eye. I have been helping someone thru the first weeks of the surgery and she is doing well. We started her out on a preop diet that helped her lose 10 pounds in the three weeks up to her surgery and then got here blood sugar lowered to where she was closer to normal .after the initial clear liquid post op she was back on the same plan and has slowly introduced her soft meats and kept her preop plan going and 1 month post op she has lost 30 lbs and has no cravings and has been doing well.

The plan called for a nutritional supplement that is water soluble so the pills can be disolved in water that is used to mix a meal replacement shake...It takes her roughly 2 hours to get the shake drank in the morning and the same in the evening .Low glycemic meals in between help her to keep going and a great support team to help her . If you are at all interested I can give you all the info and support you need.

There are really great plans out there to help get you thru this . You do not have to be alone thru this.

Nancy...

I am going to suggest that you find a way to get hold of the Journal of Bariatric Surgery for last month. There is a must read article on WLS and diabetes. If you are interested in the over simplified version of that article I can track that down for you, feel free to PM me for the info and I'll dig it up. But the long version is a must read for you.

The article discusses bypass and how 83% of insulin diabetic patients who have bypass/DS do not need insulin within 3-10 days of surgery. It's not the weight loss or dietary changes that act that drastically, it is something different.

Then they talk about banded people. For those who are banded and diabetic they don't have the drastic BS changes after surgery but they *do* have similar drastic changes as they lose weight.

I will be seeing the person that loaned me the journal so I could read the article soon. This week as a matter of fact. If I can get hold of that journal again I'll try to make a copy of it and send it to you. It's a MUST READ for any diabetic WLS patient.

I would love to see that as well! If possible can you fax to my office at 416-813-7969 attention: Susan Silverstein - or can it be scanned and emailed?

This is very kind of you WABB

WasaBB--there's a long list...but if you can also e-mail me with the info that you have on the article you're mentioning, I would love to get my hands on it. DH is an Insulin Diabetic and we're hoping that after being banded, his diabetes will get better (God willing!!!). Great question, great responses. Good luck to you all...

-Lili

I found the over simplified version of the study. This is NOT in the detail that we all need to read and understand but it's the best I can do at the moment. The doctor that loaned me his American Bariatric Surgeon Journal (not the exact name, I don't recall the exact wording in that journal) loaned his journal out to someone else and hasn't received it back yet. But here is the overly simplified version of the study:

Welsh Medics To Examine How Surgery Can Cure Diabetes

>>Scientists at Swansea University's School of Medicine have been awarded more than £93,000 by the BUPA Foundation to investigate why weight-reducing surgery can lead to the almost immediate disappearance of diabetes in patients.

95% of morbidly obese people those with a Body Mass Index of over 40 have Type 2 diabetes, sometimes known as maturity-onset diabetes.

However, nearly 80% of patients who undergo gastric bypass surgery to reduce the size of their stomachs and small intestines find that their diabetes disappears within two to three days before any weight loss has occurred.

Senior Clinical Lecturer Dr Jeffrey Stephens is leading the research at the School of Medicine's Diabetes Research Group. He said: "Although patients with Type 2 diabetes do not always require insulin treatment, the average diabetic needs about 30 units of insulin a day to control blood sugar levels.

"For obese patients, this can rise to 200 units a day. To go from such a high level of insulin-dependency to not needing insulin in a matter of a few days is a dramatic result, and we need to understand the reasons why this happens."

The research team, which includes Professor Steve Bain and Professor Rhys Williams from Swansea University's School of Medicine, and Professor John Baxter, a bariatric surgeon with Swansea NHS Trust, are focusing attention on a Protein known as Glucagon Like Peptide 1 (GLP-1), which is produced in the small intestine.

Dr Stephens said: "Overweight people who have Type 2 diabetes tend to have lower levels of GLP1 and we are investigating whether these levels return to normal after bariatric surgery. Basically, we want to know whether reducing the size of the small intestine and stomach restores production of GLP1, and why this should be the case."

High blood sugar seen with poorly controlled diabetes may cause lethargy, excessive thirst and susceptibility to infection, and contributes to diabetic complications including premature heart disease, stroke, blindness, and gangrene.

"Bariatric surgery is not just effective in terms of controlling obesity. It clearly has other major health implications, with the potential to impact positively on Type 2 diabetes and other associated conditions. There is also the potential for the NHS to generate substantial savings in long term treatment costs," added Dr Stephens.

"Not only will this research improve our understanding of why overweight people develop Type 2 diabetes, it may also lead to an effective, non-surgical treatment for those with the condition. We are immensely grateful to the BUPA Foundation for giving us this opportunity."

SWANSEA UNIVERSITY OF WALES

Singleton Park

Swansea

SA2 8PP

http://www.swan.ac.uk <<

For the latest on various obesity related studies, check out the following. I try to read through most of these at least weekly if not daily.

Obesity News & Weight Loss News & Fitness News from Medical News Today

It is updated daily.