Diabetes

[southernlady]

I mentioned here that my A1C had started climbing again. When I had my March lab work, it was back to 7.4. Got put on metformin, 500 mgs to start and at my one month follow up, my PCP increased it to 1000, split in two doses.

Okay, last week, I had a repeat A1C. Found out today it was down to a 6.6. So metformin is working. It might not work long term just as the DS did not work long term FOR ME.

For those who don't remember, the DS has the best resolution rate for diabetes of all WLS, but it still is only 95-98%. That means for 2-5% of us, it either doesn't resolve or doesn't stay resolved.

Before asking:
No, it is not my food choices.
No, it is not my weight. I am still a normal (as in under a 25) BMI.
Yes, mine has a genetic component...my daddy, an uncle, my paternal grandmother, and my oldest half sister were or are diabetic or pre-diabetic (in the case of my oldest half sister)

Thankfully my PCP was very understanding...he didn't mention my weight or way of eating. He simply said that it can happen as my pancreas was probably worn out by the time I chose to go on insulin in 2003. And altho the DS gave me a 6 year break, it does happen.

My diabetes was diagnosed in 1997 but due to the way the medical community tested in the early 90's, I should have been diagnosed in 1994. Now the medical community looks at A1C, and 2 hour post pradial blood sugar readings. Back in 1994, they ONLY looked at fasting blood sugar and mine was 75. It was a GTT in 1994 that caught my reactive hypoglycemia. Fasting was 75, 2 hour was 250, 3 hour was 50.

Now, 6.6 is still not ideal but it is much better than a 7.4

 

[Clematis]

I'm sorry this has returned and I hope your A1C continues to decline.

 

[Settledownnow]

I am sorry also that your AIC started to climb, but I would imagine without DS your diabetes would be much worse. Let's hope this is just a temporary set-back and you will continue to improve.

 

[JackieOnLine]

sorry to hear it, Liz. at least you are on top of it & it's coming down again.

 

[KathrynK]

Liz, so glad you are getting control with only metformin and that it is already dropping.
Thank you for sharing with those of us who had diabetes prior to DS. I understand Marceau in Canada is accumulating 30-year post-op data. In their 20-year data of more than 2,000 patients, they have seen a slight relapse rate over decades in previously diabetic patients (4%), but not a single case of newly developed diabetes after DS. There's a reason for new patients to get the DS before they develop diabetes. Like you said, once it is totally exhausted, the pancreas can only run so long. You have an enlightened doctor. Mine always scolded me, despite my overwhelming family history.

The long term relapse rate of diabetes in those who get the 200+ cm common channel will be something to watch.

 

[southernlady]

Liz, so glad you are getting control with only metformin and that it is already dropping.
Thank you for sharing with those of us who had diabetes prior to DS. I understand Marceau in Canada is accumulating 30-year post-op data. In their 20-year data of more than 2,000 patients, they have seen a slight relapse rate over decades in previously diabetic patients (4%), but not a single case of newly developed diabetes after DS. There's a reason for new patients to get the DS before they develop diabetes. Like you said, once it is totally exhausted, the pancreas can only run so long. You have an enlightened doctor. Mine always scolded me, despite my overwhelming family history.

The long term relapse rate of diabetes in those who get the 200+ cm common channel will be something to watch.

Unfortunately, based on my history, I should have gotten the DS at a minimum of 20 years ago but it wasn't until 2001/2002 that my BMI came even close enough to qualify.

I hope that by sharing my journey, others will learn.

 

[galaxygrrl]

Sorry this is happening. I hope your A!C gets under control easily.

 

[hilary1617]

Liz, Glad you are on top of this and sorry it has returned. All the best!

 

[LindaDarnell]

I mentioned here that my A1C had started climbing again. When I had my March lab work, it was back to 7.4. Got put on metformin, 500 mgs to start and at my one month follow up, my PCP increased it to 1000, split in two doses.

Okay, last week, I had a repeat A1C. Found out today it was down to a 6.6. So metformin is working. It might not work long term just as the DS did not work long term FOR ME.

For those who don't remember, the DS has the best resolution rate for diabetes of all WLS, but it still is only 95-98%. That means for 2-5% of us, it either doesn't resolve or doesn't stay resolved.

Before asking:
No, it is not my food choices.
No, it is not my weight. I am still a normal (as in under a 25) BMI.
Yes, mine has a genetic component...my daddy, an uncle, my paternal grandmother, and my oldest half sister were or are diabetic or pre-diabetic (in the case of my oldest half sister)

Thankfully my PCP was very understanding...he didn't mention my weight or way of eating. He simply said that it can happen as my pancreas was probably worn out by the time I chose to go on insulin in 2003. And altho the DS gave me a 6 year break, it does happen.

My diabetes was diagnosed in 1997 but due to the way the medical community tested in the early 90's, I should have been diagnosed in 1994. Now the medical community looks at A1C, and 2 hour post pradial blood sugar readings. Back in 1994, they ONLY looked at fasting blood sugar and mine was 75. It was a GTT in 1994 that caught my reactive hypoglycemia. Fasting was 75, 2 hour was 250, 3 hour was 50.

Now, 6.6 is still not ideal but it is much better than a 7.4

I follow closely ur posts abt diabetes resolution after DS, bc of my husband who was a chronic diabteic b4 his surgery. He was off all insulin within a week post-op and his numbers for A1C and glucose were awesome during his 1st 3month labs. But i warn him not to think of himself as "cured", because it can return. He has a strong genetic component, and like u his diabetes went undetected for years before his daignosis. So by the time he realized he had it, his body was beat down. We say that his diabetes is in "remission" and that he's still a diabetic. This is a constant reminder to us both that he has to be mindful and vigilant in monitoring his body.

 

[southernlady]

Saw a new PCP yesterday here in FL. Based on my readings, he’s doubling my metformin from 1000 to 2000 mgs. But we are splitting it into 4 doses to avoid the extended release metformin.

 

[Susan in Tennessee]

Sorry you're having to do this, but glad you're on top of it. Is the PCP good to work with, does he get what surgery you had?

 

[southernlady]

Sorry you're having to do this, but glad you're on top of it. Is the PCP good to work with, does he get what surgery you had?

Kinda...and other than questioning why ferritin and why vit E (he is ordering them just not sure why until I explained the ferritin was the savings account of our iron and we malabsorb SO much, he's willing to order labs. It helped that our last PCP was very willing to order DS labs. So along with the reader's digest version to make it easier for our new one to see what labs were there, we both had copies of the last labs that were run by our previous PCP thru LabCorp.

 

[JackieOnLine]

Based on my readings, he’s doubling my metformin from 1000 to 2000 mgs.

I'm sorry you need this, Liz, but glad you have a doctor sounds like you can work with.

where in Florida are you? and do you like it?

 

[southernlady]

I'm sorry you need this, Liz, but glad you have a doctor sounds like you can work with.

where in Florida are you? and do you like it?

About 30 miles west of Tallahassee just off I10. If you see Marianna FL on the map, you've gone too far.

 

[southernlady]

Hi..

What is wrong with extended release metformin?

Does it have something to do with the DS??

Yes. It has a coating that makes it hard to absorb. Not all extended release affect everyone the same way but with my diabetes, I wasn’t gonna chance it.