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Can I Take Metformin After Gastric Sleeve

Pcos And Still Taking Metphormin Post Op?

Pcos And Still Taking Metphormin Post Op?

PCOS and still taking Metphormin post op? I was wondering what advice any of you have got in regards to taking Metphormin after you have had surgery for PCOS. My doctor just shook his head and said, "Oh no you will not need that anymore. It is all about calories". Although I am satisfied with my weight loss I know it would be more if I was takeing my Metphormin. I also have not had a period. Any comments would be appreciated. I stopped taking Metformin three weeks before my surgery, and I am convinced that I don't need it any more. Since my carb intake is close to nothing my bloodsugar is under control and that does the trick for me. I'm pre op but I still take my metformin b/c it helps me control hunger... I have pcos well at least that was what I was told. My wls dr, had told me that after surgery and loss some wieght that it will go away. I havent taken anything for it before wls and was just waiting til wls date and I will find out if i still have pcos . I just got blood work done for my thyroid and I hope I find out if I need to take something for it. I stopped taking my metformin the day before surgery (June 2008) and haven't needed it since. 3 months after surgery I went to see my endocriologist and my a1c, testosterone, and insulin levels were all normal. At almost 11 months out I've lost 125 pounds and I don't feel that there were any weird side effects from me stopping the metformin cold turkey. I stooped metformin 3 months post op. My sugars were consistantly below 120 so I was told I didn't need it anymore. I was able to stop taknig mine the day after surgery as well. Thanks for responding. I just had a hard time believing that I still would lose as much weight without it. My PCOS seems to be pretty flared with my hairy issue. I also had my period for about Continue reading >>

Metformin After Surgery

Metformin After Surgery

I was diagnosed with PCOS and insulin resistance over 5 years ago. I am having surgery on Tuesday and because it is complicated to get a liquid version of metformin I have decided not to take it for the month I'm on liquids. We all know that PCOS can be treated (to some degree) by weight loss. I did the glucose tolerance test to find out I had PCOS. After surgery there is no way that I can do that test again. I was just thinking about this myself. My surgeon actually told me that Icould stop the metformin. I had surgery on 4/18 and have not taken it since two days before that. Italked to him again yesterday and told him my concerns about stopping it right now. He was ok with that and told me to go ahead and keep taking it.I think I will wait until I get down to a healthy BMIbefore I stop taking it...and then see how it goes. Mainly, Itake it to have regular periods and a few other minor symptoms. I was taking 2000mg metformin daily and my surgeon told me to discontinue after surgery. I've never had issues with blood sugar, just insulin resistance, so I also question discontinuing it. My gyn told me that PCOS won't go away -- it's hormone related -- but that weight loss will help the insulin resistance. So I guess I don't have anything of value to add except I'm with you on the question!! I am a little rusty in my knowledge of PCOS and IR as I did do ALOTof reading in 2006 when I was first diagnosed but that was 6 years ago :) PCOS can go away. It's a hormone imbalance and losing weight can cause your hormones to become balanced. The issue with PCOS is that it's sort of a negative diagnosis - if you have certain symptoms with no other reason then you are told you have PCOS. My nurse in the hospital gave me a study that showed that almost all the symptoms of PCOS (hair g Continue reading >>

Modelling The Absorption Of Metformin With Patients Post Gastric Bypass Surgery

Modelling The Absorption Of Metformin With Patients Post Gastric Bypass Surgery

Received date: February 13, 2014; Accepted date: March 27, 2014; Published date: March 31, 2014 Citation: Almukainzi M, Lukacova V, Lbenberg R (2014) Modelling the Absorption of Metformin with Patients Post Gastric Bypass Surgery. J Diabetes Metab 5:353. doi: 10.4172/2155-6156.1000353 Copyright: 2014 Almukainzi M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Purpose: Gastric bypass surgery in obesity shortens the length of the small intestine, which can have a significant impact on drug absorption . Literature reports that the observed drug absorption patterns after gastric bypass surgery are sometimes unexpected. One report states that the absorption of Metformin was higher after gastric bypass surgery. The purpose of this study was to investigate the mechanistic background of the reported data using Advanced Compartmental Absorption and Transit (ACAT) model and apply it to patient data with post gastric bypass surgery. Methods: GastroPlus 8 (Simulations Plus, Inc.) was used to develop a model that describes the observed absorption of an immediate release (IR) metformin tablet in healthy subjects. The data was taken from a published article that compared the absorption of metformin between a control group and post gastric bypass surgery patients. The model was fitted against the data for the control group and then used to predict the drug absorption in post gastric bypass surgery patients by changing the related GI parameters. All assumptions to explain the observed data, suggested in the literature, were tested by changing the appropriate parameters in the software. Result Continue reading >>

Treatment Of Diabetes Prior To And After Bariatric Surgery

Treatment Of Diabetes Prior To And After Bariatric Surgery

Go to: Introduction Type 2 diabetes (T2DM) is a major health problem with increasing incidence in the Western world as well as in developing countries. The disease is chronic and the treatment involves lifestyle changes, oral antidiabetic drugs, and/or injections of insulin or glucagon-like peptide-1 (GLP-1) analogs as well as treatment for any ongoing hypertension and/or hyperlipidemia. Although the mortality from cardiovascular disease in diabetes seems to decline over time, it is still at least double compared to that in a nondiabetic population.1 Diabetes is associated with obesity; the more obesity, the greater the risk for T2DM. Current recommendations for bariatric surgery are based on body mass index [(BMI), body weight (kg)/length (m2)]. Body mass index >25 is classified as overweight, and BMI >30 is classified as obesity. Similar to diabetes, obesity is also associated with increased risk of morbidity and mortality. The total risk of premature death has been reported to be increased at least two-fold in patients with obesity compared with normal-weight subjects.2 Moreover, the risk of death from cardiovascular disease has been reported to be increased three- and five-fold in obese women and men, respectively, and there is an increased risk for several types of cancer.3 Treatment modalities for obesity include lifestyle changes, diet regimens, pharmacological treatment, and bariatric surgery. Of these, surgery is the most efficient alternative and has been demonstrated to be associated with maintained weight reduction as well as with effects on obesity-associated conditions such as T2DM. Today, the most commonly used limits to qualify for bariatric (weight-reducing) surgery in Europe as well as in the United States are a BMI of 35 with comorbidity and 40 withou Continue reading >>

Can Metformin Be Taken Before Or After A Sleeve Gastrectomy?

Can Metformin Be Taken Before Or After A Sleeve Gastrectomy?

Sleeve Gastrectomy and Weight Loss Metformin and PCOS Sleeve Gastrectomy and Pain Metformin and Diabetes Sleeve Gastrectomy and Weight Gain Metformin and Clomid Sleeve Gastrectomy and Protein Supplement Metformin and Weight Loss Sleeve Gastrectomy and Surgery Metformin and Pregnancy Treato does not review third-party posts for accuracy of any kind, including for medical diagnosis or treatments, or events in general. Treato does not provide medical advice, diagnosis or treatment. Usage of the website does not substitute professional medical advice. The side effects featured here are based on those most frequently appearing in user posts on the Internet. The manufacturer's product labeling should always be consulted for a list of side effects most frequently appearing in patients during clinical studies. Talk to your doctor about which medications may be most appropriate for you. The information reflected here is dependent upon the correct functioning of our algorithm. From time-to-time, our system might experience bugs or glitches that affect the accuracy or correct application of mathematical algorithms. We will do our best to update the site if we are made aware of any malfunctioning or misapplication of these algorithms. We cannot guarantee results and occasional interruptions in updating may occur. Please continue to check the site for updated information. Continue reading >>

Pcos After Gastric Bypass

Pcos After Gastric Bypass

My heart goes out to all the stories I have read thus far. I have a similar yet different story than some. I didn't see anyone mention Gastric Bypass Surgery as a resort and now again fighting PCOS. I most likely had PCOS since I hit puberty and have many family members who do too but it was not diagnosed. I always knew there was something wrong with my body but no one would really listen. Fast forward to age 19 was put on BC for first time (Norplant) and gained 30 lbs before I even knew what hit me. Didn't change my symptoms of PCOS at all and once I tried to get it removed a couple of capsules broke. I feel with that and the new weight that set more of the weight gain component into motion and I started gaining (literally) 10 lbs a week. Despite my eating "Atkins and Zone" and starting my new-found love affair with protein drinks (LOL) AND exercising with my husband for 60 minutes a day I continued to gain quickly. I lost only self-esteem and dignity and the patience of my new husband. I gained 140 lbs in a year. I was tossed around to many doctors for a year before finding one who said, "You have PCOS, eat more protein and drink less water and take this spironolactone." I didn't understand what I had; I was exhausted physically and mentally with the whole process and just beat down from all the issues. I didn't know he was trying to tell me I had PCOS and how to manage it...he didn't really say that, he just brushed me off like saying I have high blood pressure. I lost 90 lbs and became pregnant with my first child. I still didn't understand PCOS so I gained the 90 lbs. back during pregnancy and continued to gain after giving birth. My hormones were whacked out and my self esteem was gone. I hadn't really changed my lifestyle and just yo-yo dieted out of frustration Continue reading >>

Metformin After Sleeve?

Metformin After Sleeve?

So I've been on the forums lately about not losing any weight since my sleeve - in fact I've gained 2 pounds. Well I think I may have an idea. My surgeon discontinued my Metformin which I have been on for years cold turkey the day before my surgery. As an RN I wasn't comfortable with this but followed his orders. I questioned him about it at my 2 week post op visit and he asked me if I had been checking my sugars. I reminded him AGAIN that I don't even own a glucometer because my HbA1C has been 5.8% on Metformin. He just laughed and said see I cured you - he hasn'd done any labs or glucometer checks of my sugar. My PCP prescribed my Metformin. So I've put in a call requsting to restart my Metformin. I don't feel well , my metabolism is out if whack and frankly I have no confidence in him at all. He was the only Bariatric surgeon in my area on Lynne insurance plan. My NUT just trys to sell me Vitamins and Protein Powder when I go that's it. I think I may just follow up with my PCP The surgeon only wants to see me one more time at 3 months anyway. Can you believe he didn't even examine my wound's until I insisted!! sorry you've haven't lost weight since WLS not that this helps much, but there are other people in similar situations might take longer than you like, but hopefully you will see improvement sooner than later "God GIVE ME PATIENCE, JUST HURRY UP ABOUT IT!!" YOU are the RN, so what i say is from a laymen who is 3+ years WLS. 2+ years GOAL maintaining 105 lb weight loss (little fluctuation) "don't feel well , metabolism out if whack and no confidence in him at all (surgeon)" I'm not the RN like you, (not being sarcastic) but i don't think the metformin in this case is the culprit of how you feel your tummy has gone through major surgery surgery also would/can eff Continue reading >>

Gastric Bypass Increases Metformin Bioavailability

Gastric Bypass Increases Metformin Bioavailability

Home blog Gastric Bypass Increases Metformin Bioavailability Gastric Bypass Increases Metformin Bioavailability One of the concerns of undergoing gastric bypass surgery is the impact on gut absorption of essential nutrients. Although, with modern gastric bypass surgery, the length of gut that is bypassed is rather limited (around 80-120 cms) and all known nutritional deficiencies are generally manageable with dietary monitoring and supplementation, the impact of this surgery on medications is less well known. Thus, although most patients undergoing gastric bypass surgery will experience substantial improvement or even remission of many obesity related comorbidities, they may still require to take medications for conditions that persist, reoccur with subsequent weight regain, or are unrelated to excess weight in the first place. This is also true for diabetes medications. While most patients can often discontinue their diabetes medications after gastric bypass surgery, this is not true for all patients and some, despite experiencing marked improvement in the first few years after surgery, may find diabetes creeping back (which is why it is fairer to use the term remission rather than cure in this context). This means that there will always be patients who have undergone gastric bypass surgery who may require to continue on or restart their diabetes medications over time. One of the most widely used oral medications for type 2 diabetes is metformin, a drug that activates the enzyme AMP-kinase and primarily acts by reducing sugar production in the liver (gluconeogensis). In addition, metformin has positive effects on insulin sensitivity, glucose uptake and fatty acid oxidation. Unfortunately, however, metformin also has rather low bioavailability and slow, incomplete gast Continue reading >>

How Does Weight Loss Surgery Affect Diabetes

How Does Weight Loss Surgery Affect Diabetes

Bariatric Surgery , Blog , Diabetes , Dr. Hector Perez Dr. Hector Perez, Bariatric Surgeon, Cancun Dr. Hector Perez is an experienced board certified surgeon specializing in bariatric weight loss surgery in Cancun. Today he discusses how weight loss surgery affects Diabetes. Hello, my name is Dr. Hector Perez. I am a bariatric surgeon here in Cancun with Ready4aChange. Today were going to talk about Diabetes, Type II Diabetes, and bariatric surgery. Will Bariatric Surgery Help Control Diabetes? The first question we get from our patients is, Will bariatric surgery assist me in controlling my diabetes? And the answer is yes. All endocrinologists and family medical doctors around the world ask diabetic patients to lose weight. And thats very important because when you lose weight your cells are prone to work with your own insulin. So, yes, it will help you to get a better control of your diabetes. Will I Still Have to Use Insulin or Metformin After Bariatric Surgery? The next question is, Will I still have to use insulin or metformin? Thats a tricky question. Why? Because it depends on many factors. The first factor is how long have you been a diabetic. Its not the same if youve been a diabetic for 1 or 2 year, or more than 10 years. Its not the same if youre just using oral medication or if youve already started insulin. In the case of patients just with oral medication, its fair to say with bariatric surgery your diabetes is going to go into remission. You wont need any more oral pills. If you are already using insulin, you may go down from insulin to oral medication. Which Bariatric Weight Loss Surgery is Best for Diabetes Another important factor is, Which surgery is better for me? If youre just one year diabetic with big BMI, getting a gastric sleeve will most likel Continue reading >>

Diabetes / Metformin Pills

Diabetes / Metformin Pills

I am one week post op and was told to decrease my diabetes meds from 2000 mg of Metformin and a one a day dosage of Glyburide in the morning, to 1000 mg of Metformin and no Glyburide. My problem is that after I take my Metformin, I have noticed it in solid form in the toilet after a BM. I am having serious doubts to its effectiveness from that location! How do I get it to absorb?? Did I drink too much when taking them and flush them too quickly through my pouchie? I break them up into 4 small sizes so that I can tolerate swallowing them. I'd be checking with the pharmacy to see if they are crushable pills. If they are, crush them. Otherwise, you'll likely not get much use out of them. In time, hopefully you'll be off all the meds. It took me about 3 months to be able to fully wean off insulin, cholesterol and blood pressure meds .. SO happy not to have to take those! if they are safe to crush, yes. Check with the pharmacy. I don't remember if they are okay to crush or not. I used to use those tiny medicine cups the hospital gave to me.. crushed my pills (I was not allowed ANY whole pills at all for six months post op, everything had to be crushed).. I would take my crushed pills.. add a tablespoon or two of flavored water.. stir quickly and drink. Other people crush them in applesauce. I just wanted it done & over with. In the hospital they crushed mine and mixed it with jello and it was horrible. I gaged to get it down..Yucky!! Then they said I could crush it into tiny piece's and take it that way. 2 days after being home from surgery I was completely off metformin I called the pharmacy and they told me that if its the ER version of Metformin (extended release) then its not to be crushed. But that the non ER version should be fine to crush and take. So right now I am Continue reading >>

Post Bariatric Surgery Questions

Post Bariatric Surgery Questions

Posted on October 7, 2010 at 1:37 PM in Bariatric Surgery , Weight Loss Surgery After pondering about potential topics for this month, I decided to focus on post op follow up concerns. I have tried to compile the most important questions patients have regarding follow up, medications and treatments after surgery and my responses to them. First off, it is important to remember to never stop a medication abruptly unless advised to do so by the hospital, the primary provider, a specialist or our office. Surgery is not a miracle pill. A surgery does not warrant stopping needed medications. Initially, some may be stopped (such as some diabetic and blood pressure medications) but not all. The patient and his, her primary care provider and specialist must work together to decide when and if medications can be stopped SAFELY. After Bariatric surgery, hypertensive medications may need to be adjusted. The patient must first monitor his, her blood pressure twice daily in assessment of lower (or higher) blood pressure. Initially patients are told to hold medication if BP is <140/90. This is for a good reason. If borderline on this number and a medication is inadvertently dosed, it could unsafely lower blood pressure causing untoward side effects such as dizziness, lightheadedness or even syncope (passing out). I will add that beta blocker (medications ending in an OLOL) dosages may need to be reduced but the patient must be careful about stopping these without a doctors supervision as this type of medication has other functions besides lowering BP. If a patient is in doubt about what medications to take or not take, he or she is advised to consult the primary care provider or specialist who manages the medications. With diabetic medications, the patient is initially told to monito Continue reading >>

Type 2 Diabetes Management In A Post-bariatric Surgery Patient

Type 2 Diabetes Management In A Post-bariatric Surgery Patient

Type 2 diabetes management in a post-bariatric surgery patient Type 2 diabetes management in a post-bariatric surgery patient A patient, aged 57 years, was admitted to the hospital to undergo gastric bypass surgery. He had a history of type 2 diabetes for ten years. Diabetes management in a pre-, post-bariatric surgery patient A patient, aged 57 years, was admitted to the hospital to undergo gastric bypass surgery. He had a history of type 2 diabetes for ten years. Pre-admission diabetes therapy included metformin 1000 mg at morning and bedtime, insulin glargine ( Lantus ) 70 units every day in the afternoon or evening, insulin aspart ( NovoLog ) 30 units plus sliding scale three times per day. The day prior to surgery, the patient reported taking metformin 1000 mg, insulin glargine 70 units, and insulin aspart 30 units with his evening meal. His hemoglobin A1c value was 8%, and it was taken just prior to surgery. The patient's blood glucose value on admission was 204 mg/dL. Throughout the surgery, blood glucose values ranged from 208 to 214 mg/dL. Throughout the day, the patient received a total of 8 units of insulin aspart in correction doses for noted hyperglycemia. The patient was instructed to take nothing by mouth on the day of surgery, and then was advised to start a bariatric clear liquid diet on post-operative day one, advancing as tolerated. This meal plan consisted of six small, liquid meals provided throughout the day with the goal of staying hydrated. On post-operative day two, blood glucose values ranged from 90 to 103 mg/dL. The patient continued to tolerate six small meals per day via a bariatric surgery diet.He was approved to dismiss from the hospital on post-operative day two. The patient was recommended to take a multivitamin with minerals daily aft Continue reading >>

Diabetes Post Vsg Weight Loss Surgery, Weight Resistance & Metformin

Diabetes Post Vsg Weight Loss Surgery, Weight Resistance & Metformin

Diabetes Post VSG Weight Loss Surgery, weight resistance & Metformin Hi everyone, I have been a Diabetic Type 2 for over 25 years now, I have been on Metformin for over 10 years, and pre-op Vertical Sleeve GastrectomyI was on 50 units of Lantus Insulin every night, 1000mg Long release Metformin, 2-3 units of Novolog Insulin short release (when required)and Januvia. A1C June 2011 was 10.6, with Januvia and the switch to long release metformin and diet it went down to 7.0 After surgery I left the hospital off Insulin, Januvia and Novolog and my metformin was changed to the short release 750mg per day. My A1C now on based on the short release Metformin and diet, itis coming down so slowly now it is 6.5. I have lost a total of 85lbs, but for 7 months have not lost any weight. I am seeing my Endocrinologist tomorrow as I have a sneeking suspicion that the Metformin short release is causing some kind of resistance to weight loss. Once I was switched to the long release version and added Januvia I dropped 30lbs pre op, they had to put me on short release post surgery as you cannot crush the long release version. Has anyone found that Metformin short release has slowed your weight loss down or caused weight gain? I was on short release for over 8 years and it did not help with weight loss at all, my diarrhea was horrible and since being put back on the short release the diarrhea is back, thelong release helped decrease the side effect. I have type 1.5 diabetes, PCOS also and am 13 months post RNY. I am still using Lantus and Novolog insulin and metformin, albeit at reduced levels and was able to stop using a lot of other oral meds. Metformin is not associated with weight gain at all - if anything, if promotes weight loss as it addresses insulin resistance. talk to your doctor, Continue reading >>

Pcos, Metformin Use After Being Sleeved

Pcos, Metformin Use After Being Sleeved

Hi guys... I am currently 4 months post-op and on no medications. I have lost a total of 45 pounds. I still cant believe it. I am so thankful for my sleeve. Yet, I have PCOS and have not noticed my period regulating just yet. I was on metformin prior to having surgery but after surgery i was told to stop the medication. My surgeon informed me it is too soon to tell if my period will regulate since i am only 4 months post op. Yet, I was wondering if anyone was in my situation and if you had to start taking metformin again? Also, will this medication hurt my sleeve? I had really aweful side effects from it the first 3 months after taking it. I would appreciate any advice from anyone who experienced this problem. I am currently on day five of my period and it is extremely heavy which worries me because I am anemic due to my heavy periods and feel very weak. I was hoping surgery would correct this problem bit i havent noticed a change in my cycles and this really worries me. Give it more time. Be sure to get your Protein , fluids and Vitamins and if you still have irregular periods talk to both your surgeon and GYN. So I have been out for about 7 weeks and getting my period ever since the 3rd week. Prior to the surgery, my periods were missing for over a year.. I started taking metformin 3 days ago and ever since, I have been feeling very mild pain in my stomach. It's mild pain but it's there.. Is it too soon to be taking metformin?? English is my 6th language so forgive me if my sentences don't make any sense at times! I was also on metformin prior to my bypass. I have also been taking 2 Zovia per day for the past 9 mths just to keep me from having a heavy period constantly. I stopped the metformin but have not been able to wean off of the birth control. I am 11 weeks out Continue reading >>

The Case For Bariatric Surgery

The Case For Bariatric Surgery

Earlier this year, we featured a guest post by Dr. Nicholas Yphantides, a family physician who underwent dramatic weight loss, that was highly critical of bariatric (weight-loss) surgery. This surgery has recently been touted not just as a way to shed pounds, but also as a potential remedy for Type 2 diabetes . For a different perspective, Diabetes Self-Managements Quinn Phillips interviewed bariatric surgeon Dr. Michael Bilof. Quinn Phillips: What led you to become a bariatric surgeon? Michael Bilof: I used to do vascular surgery ; Im a board-certified vascular surgeon. About five years ago, I left my vascular practice and started doing bariatrics. The reason I switched was that most diabetics have, if theyre diabetic long enough, some sort of vascular problems either in their eyes or their kidneys or their peripheral circulation and end up needing the services of a vascular surgeon, either for extremity bypass, for dialysis access, or if it really gets bad, for amputation. And it was not the most satisfying practice for me. The analogy I always use is, its like closing the barn door after the cow got out. By the time they got to me, my job was not so much to reverse the process but simply to slow the rate of decline. Personally, thats not what I got into medicine for. Bariatrics gave me a chance to close the barn door before the cow got out, to see patients 20 years before they would end up seeing a vascular surgeon. QP: What proportion of your patients have diabetes? MB: Id say its anywhere from a third to 40%. I make an effort to attract diabetic patients. MB: I do two types: gastric bypass , which is sort of becoming the gold standard for bariatric procedures, and gastric banding . QP: How successful is gastric bypass in reversing Type 2 diabetes? MB: The best pub Continue reading >>

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