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| Photo by M Clock |
I saw this patient in the office last week. She was ecstatic that she took charge of her health care, went to see her Endocrinologist in regular followup earlier this year, and popped the question: "What do you think about a Sleeve for my Diabetes?"
Here's what happened...
Demographic: 46 y/o F
Start Weight: 240# BMI: 35.6
Date Of Surgery: 10/16/12
Laparoscopic Sleeve Gastrectomy
Laparoscopic Sleeve Gastrectomy
Diabetes Hx: DM2, uncomplicated, on Insulin. Lantus 65u BID, Novolog scale with meals, averaging 38 units TID. Glycohemoglobin A1C 9.2 upon entry to program. Sees PCP and has Endocrine also helping to manage her Diabetes.
Current Diabetes Hx: Currently 3 mos post op, weight down to 181, with BMI of 27. Off Insulin, and now "Diet-Controlled". BGs at home normal, Glycohemglobin pending from Endocrine visit recently. Was told on her last visit there last week that she and her PA provider would have to "Break-up" seeing each other, as her sugars, and her (DM2) disease process, was essentially in remission.
Take Home Point: Sleeve Gastrectomy, as mentioned earlier and in numerous places in this Blog, works well for Diabetes. Studies have borne this out, and the data is increasing as these patients experience long term results. In the past, the Sleeve was a portion of the BilioPancreatic Diversion / Duodenal Switch (BPD-DS), but 'recently', within the past 5-10 years, it is now an accepted stand-alone procedure producing sound results.
Due to recent improvement in insurance coverage for the procedure, and it's additional appeal as far as lack of malabsorption (and the patient's conception of what that entails surgically, as with a Gastric Bypass), and a typically shorter stay in the hospital (1 day vs. 2), it has garnered notable patient interest.
Of additional note, again an example of a patient taking it on themselves to become educated about their health, seek out alternative treatments, and, as detailed here, reap significant benefits. Weight reduced. Eating in check. HTN and Hyperlipidemia much improved, off meds. Improved quality of life.
Where would she be, health-wise, in 10-15 years with stable weight, or more likely slight but steady weight gain, and further increasing insulin resistance?
Due to recent improvement in insurance coverage for the procedure, and it's additional appeal as far as lack of malabsorption (and the patient's conception of what that entails surgically, as with a Gastric Bypass), and a typically shorter stay in the hospital (1 day vs. 2), it has garnered notable patient interest.
Of additional note, again an example of a patient taking it on themselves to become educated about their health, seek out alternative treatments, and, as detailed here, reap significant benefits. Weight reduced. Eating in check. HTN and Hyperlipidemia much improved, off meds. Improved quality of life.
Where would she be, health-wise, in 10-15 years with stable weight, or more likely slight but steady weight gain, and further increasing insulin resistance?
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