Diabetes

When I came out of hospital eight weeks ago I was told to stop using insulin and to half my metformin. Since then I have been having higher blood sugars than before, I had been doing quite a good job of keeping them between four and seven pre-op but now they're between seven and eleven. I also found that I would go to bed with a reading of seven and waking with one of eleven. During the night I would suffer hot flushes and start feeling clammy, as I am of a certain age I can't work out whether these are menopausal or whether my liver is dumping (for those not diabetic, this phrase is used when the liver believes the body sugars are low and deposits glucose into the system) anyway when I mentioned this at my post op appointment it was decided that because it was only just over a couple of weeks before I would see my diabetic consultant and that as my readings weren't overly high that I should wait until I saw him. Although it was half suggested that I could try leaving out my second metformin tablet and see what effect this had, but that I hadn't heard them say that! I have tried that, blood sugars still go up but now only to nine and a half.

The point of this entry is to ask, "how did surgery, bypass, effect your diabetes, and over what kind of time scale?"

I would be really interested to hear about other peoples experiences.

Hi

I stopped my Metformin on the day of my surgery and have not seen a BG reading higher than 6 since, I was only on Metformin and a type 2, I don't know how effective a bypass is at fixing Diabeties if you are at the stage where you are on Insulin as well.

There are others on this site better qualified in these matters than I am but I would be tempted to stay on your normal medication and keep your BG readings as normal as possible.

Paul

I find it hard not to comment (with my diabetic hat on!) However... I would have kept you on 2g Metformin a day and make sure you have a small snack before bed, and re evaluated things once 3 stone is gone, I do get a bit urrrked when they just stop Metformin - as it has great CVD protection and until some of the excess weight is gone most peoples CVD risk is still there and does not drop until the weight does...and you can't go hypo on Metformin...and it helps stop the absorption of some carbs... I will stop interfering now!
Well just one more thing...Keep a good food and fluid diary along with regular blood sugar reading from different times each day, and set your alarm and do a couple overnight - as this is very helpful for you diabetic team to confirm if you are having 'Dawn phenomenon' as we call it in the trade. Good Luck xx

Hi Oonion I was hoping for your input, can you just keep your hat on for a moment and give me an idea as to how much sugar I should keep to a day, my fitness pal says 24 which I find is very low and generally exceed, no refined sugars, just those from milk products, fruit and veg, could that be the reason I'm getting higher readings, by the way at present I'm taking one 500 mg of metformin, do you think I should increase this or wait to see consultant on May 1st?

Also meant to ask, what's CDV?

chris2710 said:

Also meant to ask, what's CDV?

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CVD even?

CVD even

i stopped my insulin after my op too but my blood sugars would'nt drop below 8 so i'm back to taking 28-32 units of humulin i of a bedtime (was taking 210 pre op) the diabetes team told me that theres a chance that i'd be back on insulin post op due to being on it for over 12 years

CVD - cardiovascular disease i.e having a heart attack or stroke (the main complication with diabetes). I really should not advice you on dosing - however I would ring your GP or clinic and just say that your BG are over 9 most days - and you think you should be perhaps taking a metformin with your 2 main meals and see what they say... I would cut out fruit completely as the fruit sugars are a lot higher than most realise - once your BG is back to a better range then you could add in 2 potions a day.
The main thing question really is are you now having symptoms from the raise? - any blurred vision, getting up to pee all the time, dry mouth, excess tiredness etc. I would imagine if your next HBa1c is raised they will up your metformin anyway...
Good Luck and try not to worry - feel free to ask anything else xx

OOnion said:

CVD - cardiovascular disease i.e having a heart attack or stroke (the main complication with diabetes). I really should not advice you on dosing - however I would ring your GP or clinic and just say that your BG are over 9 most days - and you think you should be perhaps taking a metformin with your 2 main meals and see what they say... I would cut out fruit completely as the fruit sugars are a lot higher than most realise - once your BG is back to a better range then you could add in 2 potions a day.
The main thing question really is are you now having symptoms from the raise? - any blurred vision, getting up to pee all the time, dry mouth, excess tiredness etc. I would imagine if your next HBa1c is raised they will up your metformin anyway...
Good Luck and try not to worry - feel free to ask anything else xx

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'tis witchcraft i say

Thanks for your replies, all information taken in and I will act on it, main reason I was eating fruit, other than I enjoy it, is to try to stop the constipation, will make up some veg soup so I can increase my intake of veg instead, like most I find it difficult to eat enough veg as well as protein. Going for blood tests tomorrow so will soon find out how sugars are. Just a week +, till my appointment with consultant, it was actually him that referred me for wlsurgery in the first place, whereas I'm the first patient my gp has had with a bypass, so I definitely believe diabetic consultant will know what's what.

Joffy, I remember you saying that you had had problems with high blood sugars after surgery so I had hoped for your input too. Although I've been diabetic for over twenty years I've only been using insulin for a couple of those so I'm still holding out hope there, and that I'll just see an increase in oral medication. Not bothered about the injecting, but want to avoid weight gain.

Hi

I have actually persuaded my GP to keep me on a low dose of metformin because of the CVD benefits, thanks for the tip OOnion AKA Dani ., I am on 250mg per day, which is down from 500mg twice a day before surgery, does that sound about right. I am still trying to cut out or down some of the many pills I am on.

Paul

Makes great sense Paul - I have to say If it were me then I too would want to stay on a tablet a day - not sure if 250mg would have the same effect as all the research was done on 500mg or above. It's good for keeping that carb absorption down to though. x

OOnion, sorry to hijack this thread a little, but do you have info on carb counting? my boyfriend is waiting on the dieticians appointment but it is in June, so would help if he could read up and start thinking about it himself.

It's hard work in the beginning and round here it's a week course - i-phone has a good app called DAFNE online (Dose adjusting for normal eating) I would suggest some good homework prior to course it will make things so much easier when the time comes - I would encourage getting to know the numbers now - you will need to find out what units your PCT use to measure in; as they are so up their own arses at A***** Hospital - you are only allowed to use their terminology once you have done the course...so what Joe Public knows as 10G they will call it 1SG or something like that - also a really good book, can't remember the name but will get back to you with the name.
Good Luck x

Okay thanks hun. He has brought his Hba1c down from 8.1 to 7.1 I think it was through eating healthier and lost 2 stone. So they have said this is the next step forward. I can't believe though that he hasn't been through any of this in 14 years - was diagnosed at 18

the l&d (diabetes clinic) run a course on portion sizes and carb counting ..........very handy when trying to adjust you insulin to carb intake my doctor has advised me to raise my humulin dosage by 4 units as my hba1c has dropped slightly but still sitting at 7.5


here's a link for the new blood sugar conversion page HbA1c Units Converter - DCCT to IFCC

He is not with l and d for his diabetes, but will be seeing the diabetic dietician in june for this. But I wanted to try and get some preloading done if I could.

when i was carb counting i'd have to tot up all the carbs in my meal and the insulin dose would be one third of the total of carbs........... post op i do'nt use insulin with my meals

Which type are you? He is type one, and only a few stone overweight so I don't think a bypass/etc is something he'd even consider.