Poor control since Gastric By-Pass

[Donna Type 1]

I had Gastric By-Pass January 7, 2007 and have lost about 74lbs.  I still want to lose about 25 more lbs but since surgery I am having a really hard time controlling my blood sugars.  I take 35 units of Lantus and I'm on a sliding scale of Humalog (I take anywhere from 3 to 10 units of Humalog). I just got back from lunch (I ate about an hour ago) and when I checked my blood sugar it was 310.  It has gotten to where 250 - 300 is more the normal than before when it was about 80 - 120.  My last A1C was 6.5 and I know that is within the normal range but before my surgery, it was more like 5.7.   I really hate to increase the Lantus (I'm down from 60 units) because I'm afraid it will cause me to eat more and gain my weight back.  Does anyone have any suggestions or advice?  I've been a diabetic for 26 years and have NEVER had this hard of a time and I'm terrified of causing problems with my kidneys and eyes and such.

Thanks so much!

[meurtelken]

Hi,
I'm a type 1 diabetic on an insulin pump with Apidra.
I had the surgery July 8th of this year and I'm doing extremely well. My daily doses was 135 units before surgery. That has come down to around 45 units a day. I'm real happy!

I do believe that pumpers have better control after the gastric bypass.

I used to have terrible digestion and insulin resistance. That has all gone.. I'm happy. Hope you're doing better Donna!

[vicki9168]

I know the original post was a couple years back but just wondering how you are going now Donna. I do hope you have managed to get the blood sugars sorted out and lose the rest of the weight you had planned.
Many years ago I was told that diabetics couldnt have this procedure because I would eat so little that I would be constantly in a bad way. I have found out since that it is possible but havent enquired further. i thought you would have constant lows rather than highs while the reduced insulin and food were worked out.

[ceaton]

I am considering gastric bypass surgery and was wondering how u r doing now if u resolved ur trouble with highs after meals.  wondering if u ever have trouble with lows. thats my problem

[jae31670]

I am wondering how you did with the gastric bypass itself.   I am considering having it done but I am afraid of all the post issues and problems.  I have heard so many different stories.  I didnt even know that i would even be a good person for it until I left my new endocronologist yesterday.  I always thought with diabetes i should be careful and not go for surgeries,,,,NO CLUE..I am very confused but I do need to lose a substantial amount of weight...at least 100-150  lbs

[JDRF-VOL-RL]

Hi, Donna!  You should be congratulated on your a1c's!  Those are awesome!  

Your question is a tough one.  As you know, gastric bypass changes how your body processes and absorbes food, and your insulin therapy is designed for your body pre-surgery.  If you are not seeing any side effects from the surgery which might be causing your issues, then you may need to tweak your carb or correction ratios to better deal with your highs.  You may also want to try a faster acting fast acting insulin other than Humalog.  Novolog begins acting slightly faster than Humalog.  You could also consider taking your fast acting insulin sooner, so that it is already in your system when you eat.  That can help because of the speed with which your food is now absorbed.

Organ damage is caused by poor management or lack of management of diabetes over years and years, so you shouldn't be all that concerned yet.  Good luck!