Gastric Banding to treat Type II Diabetes

allnurses Guide · Feb 25, 2009

Gastric banding has phenomenal results.. I don't know that we've been doing it in large numbers for long enough to have longterm data about recidivism though. It definitely makes sense if it's an obesity issue - the cost is minimal compared to obesity-related disease/hospitalization.

Euskadi1946 · Feb 26, 2009

Someone please pass this information on to the health insurances. Alot of them don't cover these procedures because they feel it's cosmetic.

Long Term Care Columnist / Guide · Feb 26, 2009

So how come health-insurance companies don't pay for it?? I'd have gotten it done YEARS ago if I'd had insurance benefits that are grounded in 21st-century medical science; as it is, I don't happen to have 40 grand laying around nor the ability to access that kind of cash, so the surgery isn't an option for me. I'm eligible for all the freaking maternity benefits one could possibly need---which will never be used since I'm postmenopausal---but I can't have an operation that would save my life and my long-term health. Go figure.

travel50 · Feb 26, 2009

One of my nurses (in his 50's) had it done about 3 wks ago, and has already lost 30 lbs. He looks really good, and has been able to cut his insulin in half already. He did it b/c his diabetes was so bad. He just married one of our doctors last year and has adopted her three small children. Think he wanted to be sure he hung around as long as possible for these children. He was so depressed after his wife died, and his kids left home, and he just let his health go down. Is good to see him with a new lease on life. Oh, and his insurance did pay for it.

cookienay · Feb 26, 2009

there are long term studies being done about this. THe initial data looks promising. However, for gastric banding to be a success, alot depends on the patient's compliance with the program so time will tell what the studies will show in a few years (and then 20 years). Studies are also being done with the RNY procedure. They are also researching a variation of the RNY for surgical treatment of diabetes, not weight loss. How amazing would that be??

dianajh73 · Feb 26, 2009

Gastric band is not nearly as effective for diabetes as RNY gastric bypass, which has a 78% CURE rate for diabetes, regardless of weight loss. Band is more like 40% - based on compliance. My husband and I both had RNY last year - He was diabetic and His blood sugar was PERFECT within 24 hours of surgery, BEFORE the weight loss, and has been ever since. No more insulin, or pills - NOTHING!! They don't know exactly what mechanism causes this but it is amazing - Duodenal Switch has over 90% cure rate, but is extremely drastic and has a lot of issues with malnutrition.

Cost in CA is around $25,000 with my surgeon and would do it again in a second. Luckily our insurance covered it.

RN1982 · Feb 26, 2009

More and more insurance companies are covering gastric banding or the Lap-band. I am seeing my bariatric surgeon next week and hopefully will be having the RNY procedure. For me, I want the malabsorptive side effect that comes with the RNY procedure. With the gastric banding i.e. Lap band, patients can still eat whatever they want because it's restrictive and doesn't have the malabsorption that comes with the RNY. However, it is said somewhere that even after the RNY, patients can eat sweets/high fat foods but later down the line.

My insurance company, HAP HMO, covers the procedure. I have to pay 1,000 bucks out of my pocket for the co-pay and I think it's well worth it. I've tried everything to lose weight and it's gotten to the point where I am at my heaviest, 300 lbs and it's starting to affect my life at home and at work. I'm short of breath, my back and joints hurt, I have a pannis. I'm hoping to have my surgery some time this year.

Silverdragon102, BSN · Feb 26, 2009

I too believe RNY (gastric bypass) has a higher success rate than banding. My surgeon told me that first 24 hours post op my sugars was running on the high side and probably indicated I was borderline Type 2 but having the op probably took that risk away from me. I have seen lots of type 2 diabetics on the support site I go on have wonderful results post op although a few take more than a few months for things to settle down. I have no regrets what so ever of having RNY and no it wasn't a easy decision to make and that I had tried several years or more on diets so not a cop out but something I needed to do

There is some research out there that proves it would be nice if insurance companies, health services etc depending on where you live or country take a serious look into it as I am sure at the end of the day money can be saved

classicdame, MSN, EdD · Feb 26, 2009

Bariatric surgery is recommended by the ADA for people who otherwise qualify for the surgery and are diabetic. Insurance will pay in those instances. We do Bariatric surgery in my facility and have seen positive results in the bariatric-diabetic patients. One nurse had the surgery but is still diabetic and was discouraged till I suggested that maybe her condition was not solely related to weight. In other words, she would be a diabetic regardless of weight. The lesson here is for all of us - excess weight can affect your health.

nursemike, ASN, RN · Feb 26, 2009

I was reading an article about this just the other day--sorry, I don't recall the source--and it claimed around 70% success for both lap-band and bypass, and seemed to be independant of weight loss. The author said the mechanism was unclear, but the surgery itself seemed to "cure" the diabetes. Interesting.

I'm a fairly recently diagnosed Type 2, still working on getting meds adjusted. At my last doctor visit, I was just under our guideline--our old one, anyway--for bariatric surgery (Yay!) although a Big Mac and large fries would put me back over.

Kinda scared of the surgical route, so I'll stick with the old-fashioned way, for now. But my MD made a good point--that if I was going to have it, it would be better to have it younger than older.

Eh, but then, he still thinks smoking isn't good for me.

Doctors...:smackingf

classicdame, MSN, EdD · Feb 26, 2009

There is so much that is not known about our metabolism. I am on Byetta, which is another pancreatic hormone that acts in the gut. I believe that while the hormone, insulin, plays a major role in diabetes, there are other factors as well or the Byetta would not be effective. If there is a gene that turns hunger off and on, and that is missing in morbidly obese persons, then perhaps that missing link also has an effect on diabetes. So much to learn.