A bit confused

[Ram3776]

i recently have been on a weight loss programme culminating in bariatric surgery. After all the propaganda that I would no longer be diabetic, not take any more insulin, this turned out not to be the case. My GP notes had me as T1, but the Hospital have had me as T2 for the last 22 years! After much consultation it appears that I am T1 and will remain insulin dependant, bit of a downer.
Down to 1 unit per 10g carbs but on the baristric diet this equation doesn't happen often. I have also been advised that, I should not take any insulin if my BM is below 13! Not something I agreed with, so asked my GP, a fellow T1, who advised me to follow my normal regime.
Still waiting for an appointment to see my SDN

 

[catapillar]

Hi @Ram3776 that's interesting. Are you able to expand a bit more on your story? How were you diagnosed 22 years ago? How has your diabetes been treated throughout that time? You say there's been much consultation to determine you as type 1, have these consultations included a cpeptide and antibody testing?

It appears your carb counting with your insulin dose, it you may not understand how carb counting works

Down to 1 unit per 10g carbs but on the baristric diet this equation doesn't happen often.

The equation works whether you are eating 97 grams of carbs or 5 grams. You total up the grams of carbs in what you are eating and divide by 10 to get your insulin dose. So 97g / 10 = 9.7 units, or 5/ 10 = 0.5 units. If you are eating very small meals, I understand that's what's required after bariatric surgery, have you got a pen that does half units?

 

[DavidGrahamJones]

After all the propaganda that I would no longer be diabetic, not take any more insulin, this turned out not to be the case.

First of all welcome to the forum, an informative place to be.

I was under the impression that bariatric surgery only helped type II and not type I. I also think I'm right in saying that not every type of surgery has the required effect and I thought gastric banding, for example, definitely had NO effect on type II. (needs verifying)

I'm sorry to hear that the hospital's records differed from your GP who I would have thought knew that bariatric surgery, or at least the severe calorie reduction (ref Newcastle Diet) would lead to "reversal", for want of a better word, of diabetes for type IIs.

Assuming that you would like to lose more weight (that's why you had the surgery), I sincerely hope that it goes well and that you have a successful outcome, weight wise at least. I see @catapillar has suggested a c-peptide, that will tell you what your pancreas is up to.

I have weighed as much as 27 stone after taking Rosiglitazone, losing 4 stone when I stopped taking it (it damaged my liver) and a further 4 stone when I went low carb. Still work in progress, my experience being that I eat less and less to lose anything at all, hence my reference to Newcastle (600 - 800 cals, no carbs, no protein). I wasn't suitable for bariatric surgery because after speaking to the psychiatrist/dietician combo at the hospital they decided I had a weight problem, and the patients at the support group were eating more than I did, even after surgery (I was told 1200 cals).

All the best.

 

[Ram3776]

Hi @Ram3776 that's interesting. Are you able to expand a bit more on your story? How were you diagnosed 22 years ago? How has your diabetes been treated throughout that time? You say there's been much consultation to determine you as type 1, have these consultations included a cpeptide and antibody testing?

It appears your carb counting with your insulin dose, it you may not understand how carb counting works


The equation works whether you are eating 97 grams of carbs or 5 grams. You total up the grams of carbs in what you are eating and divide by 10 to get your insulin dose. So 97g / 10 = 9.7 units, or 5/ 10 = 0.5 units. If you are eating very small meals, I understand that's what's required after bariatric surgery, have you got a pen that does half units?

Hi there,
Had the usual symptoms , thirst etc. Went to the GP as I was having difficulty staying awake. After all the tests, was placed on Metformin, this only lasted about 4weeks then placed on insulin. Been on it since May 1995. Don't have a pen that does half unit doses. Diet involves very low carbs, high protein, low fat meals about ramekin size 4 times a day at the moment. Previously it was 2 weeks liquid followed by 2 weeks baby food consistency now on mashed with a fork! My antibodies are quite high but as I have said, still waiting to see our DSN.

 

[catapillar]

Hi there,
Had the usual symptoms , thirst etc. Went to the GP as I was having difficulty staying awake. After all the tests, was placed on Metformin, this only lasted about 4weeks then placed on insulin. Been on it since May 1995. Don't have a pen that does half unit doses. Diet involves very low carbs, high protein, low fat meals about ramekin size 4 times a day at the moment. Previously it was 2 weeks liquid followed by 2 weeks baby food consistency now on mashed with a fork! My antibodies are quite high but as I have said, still waiting to see our DSN.

Well if you have antibodies then you are type 1. It's probably worth enquiring how the confusion occurred at the hospital. Was it the diabetic clinic at the hospital thinking you were type 2 or was that the surgical team doing the bariatric surgery? It may be that if further investigations were never made you were assumed to be type 2, it sounds like you were initially treated, briefly as type 2. This might not have been corrected if you didn't go on to have antibody testing - if you've only recently recieved the testing. Sorry you got caught up in confusion, and in the "propaganda" for bariatric surgery. I hope it wasn't sold to you on the basis it would get you off insulin.

Type 1 is an autoimmune disease (hence the antibodies meaning you are type 1) where the immune system kills off the insulin producing beta cells in the pancreas. That means you will need to inject insulin for life. Type 1 is currently incurable. It doesn't matter what you're BMI is or what you're eating, a type 1 will still need to inject to stay alive. So no, bariatric surgery doesn't change that. It may well reduce the amount of insulin required. Has it made much difference to your insulin sensitivity or total daily dose?

There is another poster on the forum who is type 1 and has had bariatric surgery, I'll try and remember his name, I think he is struggling with the changes to his insulin sensitivity.

Do ask your DSN for a half unit pen, it could come in handy in allowing more accurate dosing on your restricted diet.