Question:
HELP! High HbA1c

HELP! My open RNY is scheduled for next Wednesday and I got a call from the nurse today which I considered a warning. She has received and reviewed my lab results and has warned me not to go hog-wild these last few days. I am diabetic and not able to go hog-wild. My HbA1c was at 11.5 which is high for everyone else but right on target for me. In the 6 years I have had diabetes, I have seldom been below 10. She said she didn't want to scare me but the blood drawn the day before surgery could cause a delay. I am very upset and stressed out. If I could control my diabetes, I wouldn't need this surgery. But if I can lose the weight, there's a chance I could get off the insulin. Could I get some reassurance or real-life experiences without hearing that every surgeon has different standards. I don't know if I should call her back and get some clarification or if she was just making a general statement. Thanks so much!    — Jennifer M. (posted on August 29, 2003)

August 29, 2003
I wouldn't worry TOO much. 11.5 is pretty high, so they just want to make sure that between now and surgery you try to stick to your ADA diet instead of pigging out with Last Supper Syndrome like some of us have done. My friend used to take 300 units of insulin a day - yes 300! He takes no meds at all since the surgery. All you can do is eat wisely for the next few days - so worrying about it really won't change that. If they thought this was a reason to cancel the surgery, they wouldn't wait until the last minute.
   — bethybb

August 29, 2003
Jennifer... my hemoglobin A1C was 11.3 last October when I was SUPPOSED to have my open RNY and my surgeon refused to do the surgery at that time until my number was 8.0 or below. Your body's healing abilities will be MAJORLY compromised with sugars this high and from my understanding, many surgeons won't operate, and for good reason. I was able, in six months, to bring my A1C down to 6.6, with some slight changes in medication. I'd think twice before going under the knife with such "cards stacked against you." Just my opinion, but your surgeon is the best to help you make this BIG decision!! God bless & best wishes!!
   — Amy G.

August 30, 2003
Why is your hba1c so HIGH?? Rather, why does your doc allow it to remain that high?? If mine went over an 8, my doc would flip and up my oral meds and insulin... are you are more than just insulin?? If not, have they tried adding in metformin (helps your body use your insulin)? If they haven't, you might ask them to consider it... it can drop your hba1c dramatically! I was at a 13.5 and on insulin and they added metformin and I went down to a 6.8 -- now, 20 months post op I am off ALL meds and my hba1c is a 5.6!! Try the metformin in addition to your insulin if they haven't already... and if they have, how much are you taking? I had to take 3000 mg each day to get mine to come down to 6.8!! That's WITH four insulin shots per day!! Good Luck!!! Hugs!
   — Sharon m. B.

September 1, 2003
Original poster here....A little history. When I was diagnosed 6 years ago with type 2, my hba1c was 19.5 and my blood sugar was 771 when I was admitted into the hospital. I have never been consistently below 11. I have no long-term effects of high levels and consider myself lucky. I know my luck will run out some day if I don't lose the weight to help with the insulin intolerance. My surgeon has spoken to my PCP in the last week to get her recommendation and what her experience has been with me. Thankfully, I have never given up and have tried numerous oral and injectable combinations. My surgery is set for Wednesday and as far as I know, that is when it will be. Thank you for sharing your experiences with me.
   — Jennifer M.

September 1, 2003
Jennifer I hear ya. Same problems with you except this year I developed complications - kidneys & eyes, not to mention have been having nausea & dry heaves daily for months and months. Anyhow, GET THAT SURGERY NO MATTER WHAT, even if it takes the strictest no carb, no sugars of any type diet for the next days. Eventually that diabetes will come back to bite you in the butt so its best to rid yourself of it NOW. Good luck in having your surgery on time!
   — Shelly S.

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