Diabetes Dramatically Improved-Pat Dittilo Shares in an Email

I received this Email from Pat Dittilo last week and she has agreed to share this with all of my readers. She said would like to encourage as many as possible. Here is what she shared:

Dr. Myers,

Hope you are doing well in your new position. I wanted to give you an update on my status since you and I have talked several times about the surgery and diabetes. I had a robot assisted gastric bypass by you in October of 2010, about 18 months ago. I was your 13th or 14th robotic case. I had type 2 diabetes diagnosed about 5 years before my operation and was on oral medicine as well as 10 micrograms of Byetta that I had to inject three times a day in addition to injecting 105 units of long acting insulin twice a day.

You may remember that my diabetes was out of control – my A1C was 11.7 and while I haven’t had it tested recently, my last A1C was 7.1 six months ago, (i will be having it checked again soon). I wanted to let you know that my sugar level yesterday and today were 94 and 89 and I am not taking any diabetic medication. I am so pleased and happy about my decision to have the surgery and even more pleased that you were here to do that for me. I have maintained my weight at 138 for over a year and I feel awesome. In addition to not taking any medication for my diabetes, I also no longer take medication for my blood pressure like I was before and my sleep apnea is completely gone. I’m 55 (almost 56) and I feel like a kid again. I have more confidence than I’ve ever had in my life.

It’s funny that so many people are more aware of the results of the surgery for those who have diabetes and the media attention it’s getting. Almost weekly I see something in the news about how people with diabetes are no longer dependant on insulin or completely cured. I can’t tell you how wonderful it is to wake up every day and not think about having to take those shots. I can eat without worrying about injecting the Byetta 30-60 minutes before I eat and how it made me sick to my stomach sometimes.

Thank you again for everything you did for me – I never thought I would feel so good again. Living my life without drugs and machines is a blessing, not to mention going from a size 18-20 to an 8-10!

God Bless you and your family. You are truly an Angel in many people’s lives.

Pat Dattilo

Testimonial Robotic Gastric Bypass

Tom Cocran had a robotic gastric bypass operation 4 months ago. He is 6 ft 4 inches tall and weighed 356 lbs. He lost 60 lbs in the Fresh Start Bariatrics program prior to surgery. He has now lost a total of 114 lbs. He no longer has type 2 diabetes with a normal HbA1c. He is no longer on diabetic or blood pressure medicine. He also no longer is on his CPAP machine for sleep apnea.

Tom shared this at the Fresh Start Seminar on April 16, 2011.

Patient Testimonial Reversing Diabetes with Gastric Bypass

Christopher Anderson had a robotic gastric bypass by Dr Myers just one week ago and now is off of all of his diabetic medicines. Chis shares his story.

Tree Reasons Type II Diabetes is Often Reversed by Gastric Bypass

How a gastric bypass can reverse diabetes Here are thee reasons

1). Early after the operation carbohydrate intake is minimal so the glucose level remains low. In fact in our practice I have patients on a very low carbohydrate diet, (650-800 calories per day), for 1 to 2 weeks before surgery primarily so they have an opportunity to use up the stored calories in there liver, (glycogen), which results in loss of water stored in the liver and the reduction of the size of the liver. This allows me to work more easily under the left side of the liver where the upper part of the stomach lives. This makes the operation easier for me and safer for my patients. What I have observed is that frequently many of my patients no longer need their diabetic medicines even before surgery as long as they continue to consume very few carbohydrates. The reduction in the amount of carbohydrates consumed is clearly an important component in this process that continues even after their operation since it takes several weeks or a few months for the amount of carbohydrate a person consumes increases and stabilizes at a new lower amount.

2). Second, since obesity is the most important reason most of our patients
develop diabetes, losing weight and keeping it off decreases the obesity and the patients lose their resistance to insulin which was caused by their obesity in the first place. Therefore the amount of insulin they are able to make is frequently enough to keep their glucose in the right range. Unlike the previous two components that decrease the blood sugar right after surgery this component takes time to show the beneficial effect of weight loss but by the time the patient is able to consume a more normal amount of starch and sugar he or she has lost enough weight to no longer need their diabetic medicines because of the loss of insulin resistance from the resolution of their obesity. This is why with some patients we need to slowly decrease the amount of diabetic medicine they are on over several weeks or even a few months.
It is important to understand that not everyone will have resolution from their diabetes. About 15 to 20 percent will still need to be on some diabetic medicines after a gastric bypass operation. The longer a person has type II diabetes the less likely it is that they will resolve their disease. However I have seen some patients resolve their diabetes after a gastric bypass operation even after 10 or 15 years of diabetes. Nevertheless even if the diabetes is not completely resolved it is much easier to manage and usually a person needs to be only on a pill they can take by mouth and they will not need to take insulin shots.

3). Finally, of these three most common operations, (gastric bypass, gastric sleeve, adjustable gastric band), the gastric bypass has an additional component that helps the diabetic. It is the hormone change that occurs after a gastric bypass. Probably the most important of these changes is the increase in a hormone like substance from the last part of the small intestine and the first part of the large intestine called GPL-1 (Glucagon Like Polypeptide-1) which increases the amount of insulin a gastric bypass patient sends into the blood stream after consuming carbohydrates.
Instead of giving yourself an injection of Byetta or Symulin, which is the injectable form of GLP-1, after a gastric bypass operation your body produces more GLP-1 on its own in response to ingesting carbohydrates resulting in better production of insulin and improved use of insulin where the insulin does it’s work.
This begins immediately after the operation and is part of the reason that many diabetics that still needed some diabetic medicines before surgery even while they were on a very low carbohydrate diet will leave the hospital after their gastric bypass operation on no diabetic medicines at all and have normal blood glucose.

If a person of size has had diabetes for 10 or 20 years, sometimes the insulin producing cells of the pancreas have been so severely damaged that they are no longer able to produce enough insulin to meet their needs even if they lose their excess weight and therefore lose the insulin resistance that comes along with obesity. Nevertheless I have observed amazing results even when I did not expect them. Even if all the patient who has had diabetes for many years are not able to stop all of their diabetic medicines, generally they are on alot less medicines and their diabetes is much easier to manage. They still should be able to maintain a HbA1c
of 6 or less.

The gastric bypass operation is a wonderful tool for persons of size who want to improve or reverse their Type II diabetes.

Diabetes Reversed by Bariatric Surgery as Viewed by Dr. Myers, Assistant Mike Palasek, RN, CRNFA

Mike Palasek. RN has been working with me as the surgical assistant for over 10 years. He is great help and has helped me with every bariatric operation that I have performed and that is over 1,000 operations. Mike has a “bird’s eye view” of how our diabetic patients do after surgery. He sees each patient after surgery in the office shortly before I see them and records their medicines and how they are doing with their weight and glucose readings. He often speaks to prospective patients who attend our Fresh Start Educational Seminars before I start my part of the presentation. I have heard him say, “I have been a nurse for over thirty years. When I first started nursing I had no idea we would be operating on people to improve their medical problems such as diabetes and high blood pressure. When I was first a nurse I gave insulin for diabetes but no one ever got better and off the insulin injections. We gave pills for high blood pressure but no one ever got off of their blood pressure pills. For me, as a nurse, it is very satisfying because instead of just managing these and other medical problems in our patients we are actually seeing these problems resolve. Now I see people getting off insulin and other diabetic medicines and it is not uncommon for patients to no longer need any medicines for diabetes. Patients who needed 3 or 4 diabetic medicines or are on an insulin pump before surgery are no longer on any of these medicines and they are no longer taking any insulin. It is surprising but we often see patients that are taking 70 or 100 or even more units of insulin every day prior to surgery taking no diabetic medicine or insulin at all with normal blood sugars. As a nurse, that is really rewarding.”

Robotic Gastric Bypass

Kathy Tells How Her Type II Diabetes was Resolved with a Robotic Gastric Bypass

Diabetes Improvement Barely Mentioned

Recently on a Sunday in late winter I stepped off the escalator on the second level of our local Barnes and Nobles book store at Easton in Columbus, Ohio and my eye caught a large group of books on the medical self just in front of me. I counted 23 books about diabetes and as I looked further no other medical subject devoted so many books to one disease. Not heart disease, not high blood pressure, not even cancer. As a busy bariatric surgeon caring for diabetic patients nearly every day, I was intrigued.

After bariatric surgery amazing things happen to improve the lives of diabetic patients. Usually I see patients with type II diabetes discontinue all of their diabetic medicines soon after bariatric surgery. Less frequently patients who have had diabetes for many many years see improvement in their diabetes, discontinue insulin but still need some diabetic medicines that they take by mouth. In fact, it is extremely rare for a patient NOT to either resolve or improve their diabetes after bariatric surgery.

Filling my arms with a copy of each of these books, I headed for the store’s coffee shop and began to read. I tuned the pages of these books for references to the amazing things I was seeing following bariatric surgery. Surprisingly, I found very little. In fact I found only three books that even mentioned bariatric surgery and only one mentioned bariatric surgery could improve diabetes.

Why is there so little information in most books about diabetes about the amazing improvement for diabetics after bariatric surgery?

I will share more thoughts about this dilemma in postings over the next week.

See patients telling their stories on YouTube by googling DrSteveMyers and selecting my channel.

Diabetes May Double by 2050, Bariatric Surgery Can Help!

Front page news in the USA Today and the Columbus Dispatch newspapers this week reported the most recent CDC prediction for diabetes in America.

1). Diabetes may increase from the present rate if 1 in 10 to 1 in 3 persons over the next 40 years.
2). Presently there is about 200,000 diabetics in central Ohio
3). It is estimated that the number of diabetics in central Ohio will increase by 13,000 every 2 years




Most of the increase will be in Type II diabetes. Why?

1). Improved diabetic care is allowing diabetics to live longer
2). Earlier diagnosis
3). Growing minority populations
4). Increasing frequency of obesity

How can bariatric surgery help?

For those persons of size who develop type II diabetes, their diabetes is resolved 84% of the time after bariatric surgery. For those who were diagnosed with diabetes within the last 5 years the results are even better: 95% of patients will resolve their diabetes.

Although all bariatric operations can help to prevent diabetes, the best operation to resolve diabetes is a Roux en-Y Gastric Bypass. A Roux en-Y Gastric Bypass is the only operation that changes to patients hormonal situation to increase the amount of insulin the pancrease produces in response to carbohydrates.

Learn more about diabetes and bariatric surgery on other posts on this blog.

Our practice is available to help as many persons of size with diabetes who want to be helped.

How do you think a gastric bypass helps to resolve Type II Diabetes?

Over 80% of Type II Diabetics show no evidence of diabetes after a gastric bypass operation. If a person has had diabetes for less than 5 years 95% of these people have no evidence of diabetes after this operation. Although we are still working out the reasons why this occurs, I believe Diabetes is improved or resolved in a three staged sequence.

1). Early after the operation carbohydrate intake is minimal so the glucose level remains low. In fact in our practice I have patients on a very low carbohydrate diet for 1 to 2 weeks before surgery and frequently they no longer need their diabetic medicines even before surgery as long as they continue to consume very few carbohydrates. The reduction in the amount of carbohydrates consumed is clearly an important component in this process that continues even after their operation since it takes several weeks or a few months for the amount of carbohydrate a person consumes increases and stabilizes at a new lower amount.

2). A second component that helps the diabetic is the hormone change that occurs after a gastric bypass. Probably the most important of these changes is the increase in a hormone like substance from the last part of the small intestine and the first part of the large intestine called GPL-1 (Glucagon Like Polypeptide-1) which increases the amount of insulin a gastric bypass patient sends into the blood stream from their pancreas. This begins immediately after the operation and is part of the reason that most diabetics do not need further diabetic medicines by the time they leave the hospital after their operation.

3). Finally, since obesity is the most important reason most of our patients develop diabetes, losing weight and keeping it off decreases the obesity and the patients lose their resistance to insulin. Therefore the amount of insulin they are able to make is enough to keep their glucose in the right range. Unlike the previous two components that decrease the blood sugar right after surgery this component takes time to show the beneficial effect of weight loss but by the time the patient is able to consume a more normal amount of starch and sugar he or she has lost enough weight to no longer need their diabetic medicines because of the loss of insulin resistance from the resolution of their obesity. This is why with some patients we need to slowly decrease the amount of diabetic medicine they are on over several weeks or even a few months.

It is important to understand that not everyone will have resolution from their diabetes. About 15 to 20 percent will still need to be on some diabetic medicines after a gastric bypass operation. The longer a person has type II diabetes the less likely it is that they will resolve their disease. However I have seen some patients resolve their diabetes after a gastric bypass operation even after 10 or 15 years of diabetes. Nevertheless even if the diabetes is not completely resolved it is much easier to manage and usually a person needs to be only on a pill they can take by mouth and they will not need to take insulin shots.

Recently I have been hearing from our patients that their endocrinologist is encouraging them to investigate bariatric surgery early after a new diagnosis of type II diabetes so it is more likely that they will resolve the disease instead of waiting for years until they have sustained injury to other organs. This is an amazing change in the attitudes of endocrinologists and I believe it represents a great opportunity for people with diabetes.

And to think I have the privilege of helping people in this way! How cool is that?

Want to make a comment or ask your question? Click on the word ”comments” at the end of this posting.

Want to have new postings I make to this blog sent free and automatically to your email? It takes less than 30 seconds. 1). Enter your email address where requested on the left side of this blog.2) Click on “subscribe” and follow directions to prevent spam.3). Click on “Complete Subscription Request”. It’s just that easy! Your email will not be shared or used for any other contact.

A patient's Success Story -Improving Diabetes- Don Swonger

The following videos are of Don Swonger telling of the changes in his life since his laporoscopic Roux en-Y Gastric Bypass as of a year ago.

Part 1

Part 2

Today I was thinking about...

Today was a good day for our patients. This morning I arrived late because of the snow, but we were able to do a laproscopic Gastric Sleeve operation on one of our patients and a laproscopic Gastric Bypass on another. After seeing my other patients at the hospital and meeting with the Statistician about some research, I was able to brave the snow once again and get to the Fresh Start Office to see the Post-Op patients that were operated on last week. They are all doing very well and it is so exciting to be a part of their journey. One patient is a diabetic who used to be on over 100 units of insulin a day. And now one week after his operation he is on no insulin and his blood sugar no longer requires any insulin or other diabetic medication. As he continues to lose the weight, it would be wonderful is he no longer needed diabetic medication. How cool is that?!The office is over now and I must brave this storm to get home to my precious wife. Hope to post again tomorrow after more operations.

"Which Operation do I choose to resolve my Type 2 Diabetes?"

This question comes up often when a new patient is interested in the Fresh Start Bariatric Program. At least 25% of our patients have Type 2 Diabetes. If your goal is to resolve Type 2 Diabetes, the most effective tools is a Roux en-Y gastric bypass. In fact 95% of patients that have had Type 2 Diabetes for less then 5 years, will have no evidence of Type 2 Diabetes following this operation. A gastric sleeve procedure is somewhat less effective and an adjustable gastric band operation is even less effective in resolving Type 2 Diabetes. Overall, 84% of patients who have Type 2 Diabetes have remission of their diabetes.