Jennyfer Reyes

Tomorrow I go for surgery at 9:45am

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Hi I have a concern... I am6 days post op & My sugar levels had dropped to 72 even tho I don't feel sick it still concerns me. Is this to low? I had type 2 diabetes before the surgery. Just wondering if this so something that has happened to anyone. It wasn't always like this after the surgery it just started like for two days now. 

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8 minutes ago, Jennyfer Reyes said:

Hi I have a concern... I am6 days post op & My sugar levels had dropped to 72 even tho I don't feel sick it still concerns me. Is this to low? I had type 2 diabetes before the surgery. Just wondering if this so something that has happened to anyone. It wasn't always like this after the surgery it just started like for two days now. 

Yes, you for sure need to get a hold of your primary care physician, or whoever treats your diabetes, and also make sure your surgeon knows. 70 is too low, only for the fact that 60 is REALLY too low, and you are almost there! 

I am dealing with this exact same issue, right now, in my pre-op diet :-)  

So until you can get a hold of someone on your team, I'm guessing your'e still on liquids? Are you still on any diabetes meds? I would have a few sips of apple juice and test 1 1/2 hours later, to see where you're at. To give yourself breathing room, shoot for between 80 - 100 right now I think.

Edited by Michael_A

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Yes I'm only 6 days post op. I sent my husband to the store to get apple juice to see if it'll work for me. I am on liquids still... 

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Now my sugar is on 66 and no I'm not on diabetes medication anymore. 

Edited by Jennyfer Reyes

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I just spoke to my surgeon. And he said its normal. As long as it doesn't go down to 50's I shoukd b fine. But even then he sais there is nothing we can do. Its my body taking its time to change. And with the diet I'm on and losing weight my sugar will drop. So he said for me not to worry. 

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On 10/06/2017 at 7:11 AM, Jennyfer Reyes said:

I just spoke to my surgeon. And he said its normal. As long as it doesn't go down to 50's I shoukd b fine. But even then he sais there is nothing we can do. Its my body taking its time to change. And with the diet I'm on and losing weight my sugar will drop. So he said for me not to worry. 

Not sure what measurements you are using - I was told to come off metaformin during my liver shrinkage and was at 9.6 mmol/L going into surgery 

post surgery I have not gone above 5.3 mmol/l - was at 4.5 this morning - guess no more db2 metaformin for me any more !

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On 6/10/2017 at 2:11 AM, Jennyfer Reyes said:

I just spoke to my surgeon. And he said its normal. As long as it doesn't go down to 50's I shoukd b fine. But even then he sais there is nothing we can do. Its my body taking its time to change. And with the diet I'm on and losing weight my sugar will drop. So he said for me not to worry. 

Your blood glucose is now normal.

In someone with diabetes on insulin or a number of other drugs, like @Michael_A is now, your doctor would be worried it might be driven lower by one of the medications. 

Honestly, no one fully understands why type 2 diabetes goes into remission so much right after WLS, but it does. Check out @NerdyLady's postings - she did WLS primarily because of her diabetes. She has lost 40 or so of the roughly 60 pounds she wanted to lose and her hemoglobin A1C levels are dead normal and she is off all of her 4 meds! @Alchemist with metric measurement near 10 before surgery had a blood glucose near 180 g/dL (old style English units we still use in the US). Now with one of 4.5 has a blood glucose of 81. Dead normal. 

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44 minutes ago, BurgundyBoy said:

Honestly, no one fully understands why type 2 diabetes goes into remission so much right after WLS, but it does.

Specifically, gastric bypass. The Dr. I was seeing for my diabetes only (not my PCP) just came out and said it- "we don't know why it works, there's just something magical about gastric bypass that almost immediately corrects blood sugar numbers".

No doubt at all though that someone with a sleeve will also see better blood sugar control, but I would guess that will come more slowly and gradually as weight is lost.

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2 hours ago, Alchemist said:

Not sure what measurements you are using - I was told to come off metaformin during my liver shrinkage and was at 9.6 mmol/L going into surgery 

post surgery I have not gone above 5.3 mmol/l - was at 4.5 this morning - guess no more db2 metaformin for me any more !

I think that's a UK thing. Here in the States, they almost always want you to be under a specific A1C, either 8 or 7. My surgeon said 7. I was close to 9 when I started my 6 month pre-op diet, but I'm guessing I'm in my mid 5's now. I don't think they'll take me off of metformin until surgery.

There is research that shows too high of an A1C before surgery puts you in a higher risk for complications afterward...

http://www.diabetesincontrol.com/a1c-is-a-predictor-of-clinical-outcomes-following-noncardiac-surgery/ 

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17 minutes ago, Michael_A said:

I think that's a UK thing. Here in the States, they almost always want you to be under a specific A1C, either 8 or 7. My surgeon said 7. I was close to 9 when I started my 6 month pre-op diet, but I'm guessing I'm in my mid 5's now. I don't think they'll take me off of metformin until surgery.

There is research that shows too high of an A1C before surgery puts you in a higher risk for complications afterward...

http://www.diabetesincontrol.com/a1c-is-a-predictor-of-clinical-outcomes-following-noncardiac-surgery/ 

Oh, yes. No going to elective surgery with out of control, or hard to control, diabetes, bad bad bad.

@Michael_A, perhaps I am mistaken, but your note suggests you may be mixing hemoglobin A1c levels with the metric measurement of glucose (mmol/L) which typically also gives numbers in the 4-10 range, which is (alas) similar to the hemoglobin A1c range of measurements. @Alchemist's note suggests the readings that s/he posted were a home testing level, which would be a glucose level. In most of the globe metric is used, and a glucose level of 5 mmol/L = 90 grams/dL in US system. Unhappily this 5 number, which is an ok one, is similar to the hemoglobin A1c boundary between normal and elevated... this has tripped me up when talking to people out of the US on this subject in the past. 

Very good article ... 

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2 hours ago, BurgundyBoy said:

Oh, yes. No going to elective surgery with out of control, or hard to control, diabetes, bad bad bad.

@Michael_A, perhaps I am mistaken, but your note suggests you may be mixing hemoglobin A1c levels with the metric measurement of glucose (mmol/L) which typically also gives numbers in the 4-10 range, which is (alas) similar to the hemoglobin A1c range of measurements. @Alchemist's note suggests the readings that s/he posted were a home testing level, which would be a glucose level. In most of the globe metric is used, and a glucose level of 5 mmol/L = 90 grams/dL in US system. Unhappily this 5 number, which is an ok one, is similar to the hemoglobin A1c boundary between normal and elevated... this has tripped me up when talking to people out of the US on this subject in the past. 

Very good article ... 

You're not wrong, I didn't realize blood sugar was measured in different units outside the US. I thought she was referring to A1c, which in this case would still work- 9.6 would be pretty high and 5.5 would be awesome!

Thanks for making me learn something new today...

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21 hours ago, BurgundyBoy said:

Your blood glucose is now normal.

In someone with diabetes on insulin or a number of other drugs, like @Michael_A is now, your doctor would be worried it might be driven lower by one of the medications. 

Honestly, no one fully understands why type 2 diabetes goes into remission so much right after WLS, but it does. Check out @NerdyLady's postings - she did WLS primarily because of her diabetes. She has lost 40 or so of the roughly 60 pounds she wanted to lose and her hemoglobin A1C levels are dead normal and she is off all of her 4 meds! @Alchemist with metric measurement near 10 before surgery had a blood glucose near 180 g/dL (old style English units we still use in the US). Now with one of 4.5 has a blood glucose of 81. Dead normal. 

Thanks @BurgundyBoy for the mighty fine intro!

@Jennyfer Reyes Congrats! Your glucose numbers are now normal! As BB said before, I had WLS because of my T2 diabetes. I was becoming insulin resistant and was on four diabetes meds. I just logged on to my online medical test results and saw that when my  A1c was tested in October 2017, it was at 10.9. My A1c was tested on May 9, 2017 (one month after my RNY), my A1c is at 5.9. I stopped testing daily and only test about twice a week. My numbers are routinely in the high 60's and low 70's. My endo is thrilled with my reports.

I am no longer taking any diabetes medications and am really emotional about how well my I have been feeling since WLS. I've slept without my CPAP machine for the last week and my husband (who is a very light sleeper) is happy to report that I am not snoring. I've lost 40 lbs and my pancreas is quite pleased with me. There is no need for concern, Jennyfer. I am very happy for you and wish you the best of luck.

Now if only my insurance company was able to show some gratitude for my improved health... *grumble grumble* 

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21 hours ago, Michael_A said:

Specifically, gastric bypass. The Dr. I was seeing for my diabetes only (not my PCP) just came out and said it- "we don't know why it works, there's just something magical about gastric bypass that almost immediately corrects blood sugar numbers".

No doubt at all though that someone with a sleeve will also see better blood sugar control, but I would guess that will come more slowly and gradually as weight is lost.

I specifically had gastric bypass because of the effects on diabetes. One surgeon tried to convince me to have the sleeve and I thought about it for a couple of minutes and found a different doctor. o_O

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10 minutes ago, NerdyLady said:

Now if only my insurance company was able to show some gratitude for my improved health... *grumble grumble* 

@NerdyLadyyour diabetes is WAAAY better ... but this delusional idea that your insurance company could show gratitude... tsk, tsk, aliens in the brain alas ...

Seriously, @Jennyfer Reyes this step of having WLS may have given you more years of life than anything else you have ever done. Just keep putting your feet in front of one another, you'll lose the weight, and keep to the healthy diet to keep it off. I GAINED 60 lbs when I was 27, you are much smarter than I was. 

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Thank u burgundyboy and everyone who has been such a great support. :D

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If you are having low blood sugar, get the chewable glucose tablets to have on hand..

i was diabetic for 18 years. Within 5 days of surgery I was off Actos, glipizide and metformin (6 pills a day)

good luck!

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57 minutes ago, Cheesehead said:

If you are having low blood sugar, get the chewable glucose tablets to have on hand..

i was diabetic for 18 years. Within 5 days of surgery I was off Actos, glipizide and metformin (6 pills a day)

good luck!

@Cheesehead Isn't it great to be off of all of those diabetes meds? I was on glipizide, trulicity, Humalin and another injectable that for the life of me I cannot remember. My doctor had to fight BCBS tooth and nail to get approval for Trulicity and Humalin. My endo's course of treatment wasn't on their approved list. I'm glad those days are over  

My wallet is happier too! My copay for Trulicity alone was $50! 

@BurgundyBoy Aw, come on! Can't BCBS buy me lunch? Considering my portion sizes, they'd probably shell out less than $5. 

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On 6/16/2017 at 11:17 PM, NerdyLady said:

@Cheesehead Isn't it great to be off of all of those diabetes meds? I was on glipizide, trulicity, Humalin and another injectable that for the life of me I cannot remember. My doctor had to fight BCBS tooth and nail to get approval for Trulicity and Humalin. My endo's course of treatment wasn't on their approved list. I'm glad those days are over  

My wallet is happier too! My copay for Trulicity alone was $50! 

@BurgundyBoy Aw, come on! Can't BCBS buy me lunch? Considering my portion sizes, they'd probably shell out less than $5. 

Well, they might ask for a volume discount and only pay $3 and leave you the co-pay. Just to keep you from ordering lunch too frequently. <_<

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On ‎6‎/‎16‎/‎2017 at 8:33 PM, NerdyLady said:

I specifically had gastric bypass because of the effects on diabetes. One surgeon tried to convince me to have the sleeve and I thought about it for a couple of minutes and found a different doctor. o_O

I too had the first surgeon I talked to try to force me into getting the sleeve, and like Nerdy decided to look elsewhere both due to this and the fact that he absolutely refused to talk about total cost, only referring to my out of pocket maximum.  While it is true that cost should not be the one deciding factor for medical care, I am so tired of double digit insurance premium increases year after year that I truly believe that it should be transparent up front, so that we as consumers can make informed decisions to help keep costs down.  If there is a surgeon/hospital that has comparable or better experience/results that costs less, we should be free to choose.  If you cannot tell my experience so far has soured me to the idea of medicine as a business.

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5 hours ago, hermit0208 said:

I too had the first surgeon I talked to try to force me into getting the sleeve, and like Nerdy decided to look elsewhere both due to this and the fact that he absolutely refused to talk about total cost, only referring to my out of pocket maximum.  While it is true that cost should not be the one deciding factor for medical care, I am so tired of double digit insurance premium increases year after year that I truly believe that it should be transparent up front, so that we as consumers can make informed decisions to help keep costs down.  If there is a surgeon/hospital that has comparable or better experience/results that costs less, we should be free to choose.  If you cannot tell my experience so far has soured me to the idea of medicine as a business.

I totally agree. But if weight loss surgery is right for you, you should get it. My surgeon gave me the choice of procedures, and I have never regretted having a gastric bypass. 

We are here to support you on your weight loss surgery journey. :)

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The surgeon I am actually going with was all about what I wanted, in fact that was the first question he asked and once he knew that my decision was based on my research he never suggested anything else.  So far I am pleased with him for the most part,(of course I'm pre op so easy to say now!) Though it would have smoothed the preop process greatly had he communicated with my PCP and supervised diet doc on what his expectations/requirements were.  They each had it in their minds an idea of what the requirements were that were in some cases in direct conflict with each other, ie. PCP insisting surgery cannot be done with an elevated a1c, and the diet doc insisting that the surgery cannot be done unless insulin is ceased and oral diabetes medicines are lessened, and in the end I had been meeting my surgeons requirements all along, they just didn't know.

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22 hours ago, hermit0208 said:

I too had the first surgeon I talked to try to force me into getting the sleeve, and like Nerdy decided to look elsewhere both due to this and the fact that he absolutely refused to talk about total cost, only referring to my out of pocket maximum.  While it is true that cost should not be the one deciding factor for medical care, I am so tired of double digit insurance premium increases year after year that I truly believe that it should be transparent up front, so that we as consumers can make informed decisions to help keep costs down.  If there is a surgeon/hospital that has comparable or better experience/results that costs less, we should be free to choose.  If you cannot tell my experience so far has soured me to the idea of medicine as a business.

Good point @hermit0208. I paid for my surgery out of pocket and the doctor who tried to talk me into the sleeve also brought up my final cost. Yes, the cost of medical care is incredibly high in the United States. However, this should not be a patient's decision making factor. In my case, I knew which surgery was the best for my health concerns, even though I paid $4,000 more than a sleeve. I weighed the cost of eliminating all of my medication copays and price of living a healthier life. 

My family will have to be on a budget for a while but I will be able to enjoy life with them instead of watching from the sidelines. 

 

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