Hello from me
@s.e london,
I'm a Type 3c following total removal of my pancreas in Feb 2020. As has been clarified by various people damage to the pancreas, not just total pancreas removal, leads to a diagnosis of T3c. Just to confuse matters I was formally discharged after my surgery categorised as T1: even though I had no previous history of diabetes and I certainly hadn't just developed an auto-immune condition!
T3c doesn't always lead to needing insulin. Indeed there is at least one member of this forum who had surgery because of her pancreatitis and seems to be managing well with just metformin. So it's a case of how much damage has the pancreas suffered. That said you are on insulin and I agree having the classic basal / bolus MDI regime gives me the lifestyle flexibility that I appreciate.
The conundrum that you might find is that because you were originally T2, now T3c after your pancreatitis, you might not find yourself transferred from GP overview to a specialist Hospital based team, which is generally only for T1, not T2. Before the NICE Guidance Notes were revised earlier this year, you would have struggled to be considered for Libre 2, the Continuous Glucose Monitor (CGM). However, there are improved opportunities now for T2s to be considered for Libre; but there is far less guidance for T3cs in general and I suspect, even though you are now on mixed insulin, you will need the active involvement of a DSN and/or Endocrinologist to help you get the fuller spectrum of support that you could aspire to as an insulin dependent diabetic. It is all a bit unsatisfactory, but since T3cs are still relatively scarce (and frequently medical people have not heard of this diabetic classification) there are relatively few precedents.
Creon is a relatively common medication for people who have Pancreatic Enzyme Insufficiency (often described as Pancreatic Enzyme Replacement Therapy (PERT) ). PERT is important if that part of your pancreas which creates digestive enzymes has been damaged by the pancreatitis. But needing Creon is not a clincher for securing 'upgraded' diabetes support; I've met a number of people who are prescribed Creon, and who are not diabetic. But for those who need Creon the capsules are not only essential for ensuring regular bowel functions, but have a significant bearing on the digestion of any carbs eaten and thus insulin dosing. I suffered from malabsorption for about 18 months, so despite rigorously carb counting my blood glucose control was very erratic - to say the least. The Creon didn't help my malabsorption, a different problem needing a special antibiotic, but if you eat and simply don't digest then there is little chance of balancing the carbs and insulin; diabetes management just becomes a guessing game!
@soupdragon's comments about being categorised as T3c but with a T1 medical ID band is very pertinent. I've made sure all my identifiers show me as an insulin dependent T3c.
Finally pancreatic damage can affect not just insulin production and digestive enzymes: your pancreas produces vitamins A, D, E and K; along with the hormone Glucagon which is used by your brain to tell the liver to open the glucose store, when your brain detects that your BG is low - your brain has no means of communicating with your liver! And the hormone somatostatin comes uniquely from your pancreas - which plays a role "adjudicating" or balancing between insulin and glucagon.
