Bit of a deflating one. I came off my diabetes tablets about four months after my sleeve in 2024 and my GP used the word remission, which I have thought about roughly once a week ever since because it felt like the best thing anyone had ever said to me.
Annual review last Thursday. HbA1c has come up. Not into the awful range, but up two years running now, and the nurse used the phrase "we may want to look at restarting something" and I burst into tears in the car park like an idiot.
For honesty's sake: I've regained about a stone from my lowest. I know that's the likely culprit and I don't need telling. What I'm actually asking is whether this is what happens to everyone eventually, whether restarting a tablet means the remission is over as a concept, and whether the surgery has stopped working or whether I've undone it. Feels like I had one chance at this and spent it.
Nobody in this section is going to tell you you've wasted it, Donna. You've had two years of tablet-free readings that you would not otherwise have had.
I can only speak from the other end of the timeline. I came off metformin in hospital, literally on the ward, before I'd lost more than the fluid, which I didn't understand at all at the time. So whatever the sleeve does to blood sugar clearly isn't only about the weight.
Not diabetic, but my blood pressure tablets went from two to one to none across the first year and then back to one about eighteen months in when things settled at a new weight.
Nobody framed that as failure. My GP called it "the dose following the man". Might be worth borrowing that phrase for yourself.
#4August 6, 2026, 8:31 am Donna, the short answer first, because I suspect it's the sentence you need: restarting a medicine is not the surgery failing, and it is not you having wasted anything.
Some definitions, since they're doing a lot of work in your review appointment. Remission after bariatric surgery means blood glucose in the normal range without diabetes medication. It is not cure, and it was never described as cure by anyone careful, because the underlying tendency to type 2 diabetes remains. Relapse becomes more likely the further out you go, and the strongest associations are with weight regain, with a longer duration of diabetes before surgery, and with having been on insulin beforehand. What relapse does not mean is a return to square one. In clinic the common pattern is exactly yours: readings drift up, one agent goes back on, and the person is still on far less medication with far better control than they had before their operation. That is a good outcome that happens to be a less spectacular one than year one.
Tracey's point is the mechanism worth understanding, because it explains why the effect isn't purely about the pounds. Glucose commonly improves within days of a sleeve, before meaningful weight has gone, driven by the drop in intake and by changes in gut hormone signalling. Weight then carries the longer-term picture, which is why regain and drifting readings travel together, and why the honest reading of your last two annual reviews is a nudge rather than a verdict. The site's guides to the sleeve and type 2 diabetes and to weight regain both cover this ground.
Three things I would raise at your next appointment, none of which are prescriptions from me. Ask whether a referral back to the bariatric service or dietetic team is available, because regain around the two-year mark is common and there is usually more they can do than people assume. Ask what the plan is for monitoring rather than just what tablet, so you know what number would change the approach. And keep every part of your routine diabetes screening going, eyes, kidneys, feet, whether you are in remission or not, because those checks exist to catch damage from the years before surgery and people quietly drop out of them once they feel well. That last one is the mistake I most often see.
Mr Ian Calloway said:
a good outcome that happens to be a less spectacular one than year one
Thank you. That's landed properly and I've read it about four times.
Eye screening is booked, I'd let it slide by about eight months, which is exactly the thing you just described and I didn't like reading it. Going to ask about the dietitian referral too. Still gutted about the stone, but "the dose following the man" is going in my pocket, Alan.
Three weeks post-op and reading this with a slightly different feeling than I expected. I think I'd assumed the diabetes bit was a switch you flip once. Useful, if sobering, to see it's a thing you keep an eye on for years rather than a done deal.
Donna, how did the appointment go in the end? And did they refer you?
