Anyone have a Lap Band as a Treatment for Diabetes?

Thread Starter  

I am hoping to hear from other type 2 diabetics who have had to take on their insurance company to get approval for a lap band as a treatment option for their diabetes. The latest literature in the medical journals for the past 2 years report that lap band surgery has been demonstrated to be a successful treatment option for diabetes, often doing away for the need for medications and reversing the complications of diabetes.

I have had diabetes for 9 years and I am needing to progressively take more medications to control my blood sugar as well as developing associated diabetes-related diseases. I am on 2 types of insulin (4 injections a day) and a diabetes pill twice a day. I also take 2 medications for high blood pressure, 1 pill a day for GERD, and use a C-PAP machine for sleep apnea every night. X-rays have verified that I have arthritis in my hips and I take 3 medications a day for depression. All of these problems are considered "co-morbidities" of excess weight and diabetes.

Because my BMI is 36.3, my insurance company, Cigna, has refused to approve my surgery request stating that my weight is borderline. They also have told me that I need to be on a 6 month doctor-supervised diet plan to demonstrate that I can lose weight.

Problem: If I do lose weight, I will no longer qualify for the surgery! Additionally, the latest medical research has shown that only 6% of people who go on a diet to lose weight maintain their weight loss for a year. It seems to be a waste of time to go through the diet regime -- I will still have diabetes and will likely be among the 94% of people who don't maintain their weight loss.

Any similar experiences out there or suggestions for how to get insurance approval?

Getting discouraged,
Sooner

Hello, I dont have the additional issues you have (which should help your case), but as for the 6 month deal with Cigna, im not sure if you actually have to lose weight, I maintained a couple of months and actually gained a couple of pounds. Of course its to your advantage to lose for your health, but I think they just want to see that a doctor has been monitoring you. All you have to do is go to the doctor once a month for 6 months and let him/her take the weight and blood pressure. If you have any questions, let me know, I just went through it

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"I can do all things through Christ which strengtheneth me" - Phil 4:13
Initial Consult - 4/4/08; Ins. Sub/Approval!: 5/16- 5/27/08
PreOp Testing 6/3&5/08 (lost 11lbs); Surgery 6/9/08!!!!
324 H / 313 S / 310 C / 145 G

The above poster is correct about the monthly dr. visits...the goal is just to get it on your record every month...not actually to lose weight. The insurance approval is usually based on 'co-morbidities' and diabetes is definitely a co-morbidity of being overweight. Do you think you might have any more....sleep apena, join pain are also in that category.

I am not familiar with any medical studies about Lap Band 'curing' diabetes....there are many, however, regarding RNY gastric bypass as a way to end diabetes....has something to do with the particular part of the intestine that is removed. In Europe, they are now using RNY to control Type II diabetes even when overweight is not an issue. But Lap Band doesn't work that way.

However......I have been a diabetic and on oral meds (lots of them) for 25 years - within 6 mo after having Lap Band, I was off all my diabetes meds and my glucose levels have been absolutely perfect for the past 2 years. It is more a matter of the old "diet and exercise", though, not the surgery itself. But I could never have done it without the surgery.....I tried for many years. The Lap Band makes it so much easier to control my eating and I've been able to detox my body from the carbs (which were my downfall)....the greatest surprise to this surgery has been the fact that I have no interest in food any more, there has never been a feeling of being deprived. I don't consider myself 'cured' of diabetes....I am "controlled" and I know if I do not continue to eat the way I should it will be back. But it's so much easier than I ever dreamed it could be.

Best wishes to you.....

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There is no use saying, 'I am doing my best.'
You have got to succeed in doing what is necessary.

Hi Sooner, I am an insulin dependent diabetic. I was on Glucophage but I have been taken off of it. I had to lose 15 pounds before. I was at a borderline. I thought they may not approve the surgery. But they did. I worked so hard that they did the surgery on March 17th. I have Blue Cross/Blue Shield. What I would do is ask them how much weight I would have to lose? If I did lose the weight would I still qualify for the Lap Band? I think I mainly qualified because my PMD said I needed this surgery because of the Diabetes. I have been a Diabetic for 15 years. It has started to affect parts of my body. Real bad Neuropathy in both legs, gastrophories.

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Thread Starter  

Thank you all for your replies!

They have given encouragment -- I was beginning to think that I should forget the whole thing. It's especially encouraging to see that the weight loss is not a must, although the monitoring by a physician is required. At first blush it seems like perhaps this a method that Cigna uses to delay and discourage their enrollees from persuing the surgery. Plus they get to keep the monry in their pocket a little longer!

I'll amke an appointment to begin my 6 month diet and exercise plan. Thanks!

Hi Sooner!
I read your first post and I had borderline diabetes. I don't now, my band has been taking care of so many of my health issue that I am just boggled at how fast and well these changes are happening in my life. 1 month after surgery..blood pressure pill prescription cut in half..2nd month of surgery..what was a liver headed for replacement started regenerating and all panels on the blood work look so well that my liver doc is weaning me off my cholesterol meds! I just went to my family doc and she cut my blood pressure meds down again to only 2 instead of 3! :biggrin2:

There was a report that came out about 3 months ago..actually the month before or the month I had my band put in so that would be late January or early February where a study was done on diabetic patients in Australia and it was stated that it was either 73 or 93% of the diabetic patients that received the band were in complete recovery and were no longer having to take medication for their diabetes they had previously. I even discussed this with my lap band doctor and he was surprised that I was up and current on the studies they were having. You can go to Lap Band sites and see what studies they are conducting and also which ones are completed. I myself am a research participant in the new AP band. Hopefully my progress will aid future bandsters with aquiring a band and showing the insurance companies just how much these bands can actually save their company in simply the medications alone that a lot of us have to take! So I think your chances of having a positive outlook on your current situation is relatively good! Keep us posted on how everything goes and I wish the best of luck for you because I know how devastating diabetes is..it runs in my family!!

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Queen of Hearts!


Teri
Banded 02/08/2008
Dr. Tim Eldridge! OKC, OK
Cool Doc! The best!

was banded march 21 2008 lost 20lbs. My questions is this . I can eat the same food time and time again and sometimes i cant hold it and other times i can Anyone know why

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A friend of mines nephew had it done mainly for that reason but he was a self pay so I have nothing to add regarding the insurance issue. But he went from taking meds as well as insulin to taking nothing at all. I know he had very poor control of it. He had it in the fall of last year, I am not sure exactly when but he considers himself cured. Good luck with getting your surgery!

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Melanie





Banded 2/14/2008
Dr. Michael Orris WLIAZ

Hi Egomec!
I don't really know why you do that but I know if I chew too little..it's not going to go down as well, or if I eat too fast same thing. If you can eat the same thing one day and it not go down the next you might pay special attention to how you're eating it..chewing and speed have killed me a couple of times, but I'm learning! I hate the results from not chewing enough and eating too fast!! Good luck!!

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Queen of Hearts!


Teri
Banded 02/08/2008
Dr. Tim Eldridge! OKC, OK
Cool Doc! The best!