Managing Type 2 Diabetes with an Ileostomy

Anyone have Type 2 Diabetes along with your ileostomy?   After getting "Maxine" in July 2017 and then getting "New Maxine" in February of 2018, my Type 2 Diabetes  disappeared completely.  Now, a little over a year after New Maxine, it has reappeared.   I am really disappointed about this as I was doing so well.  For those of you who have this duel condition, do you see your blood sugar numbers go up and down all over the place?  Also, since food processes much faster, how long after you eat should you take your sugar levels??  I have to be on medication again and I absoutly told them no way was I going to take Metformin again givin the fact that it can damage intestines.  Any info you have for me would be great.

Yes, the removal of part of the small intestine as in an ileostomy can lead to a reversal of diabetyes type 2. There are several reasons for this. These include the effect of shortening the lenghth of the small intestine on the production of specific gut hormones that will affect glucose uptake (generally called incretins and antiincretins) and hunger v. satiety. These in turn are affected by microbes in the gut, generally called the microbiome. Remove the gut, you remove part of the microbiome. A shorter gut means less sodium which is needed for glucose absorption. Less sodium, less glucose absorption. Other factors include a neural circuit and circulating bile acids. All of these are affected by removing part of the small intestine and can obviously lead to a reduction and possible elimination of diabetes type 2. This is actually the basis for successful gastric bypass and Roux-en-Y gastric bypass surgeries.

Xerxes