Hello
@SouthCoastLou,
I had a total pancreatectomy in Feb 20 to deal with Pancreatic Cancer.
I went into surgery knowing that a tumour blocking my bile duct was to be removed and that partial or total pancreatic removal was possible, but the Surgeons could only make a definitive decision once they saw exactly what was going on. So later that day I was wholly insulin dependent and not subsequently had the opportunity to review my choices!!
I received a comprehensive surgical report 2 or more weeks after my surgery which explained exactly what had been taken away and talked about an incision within 2 mm of a vein, precluding more removal. I also received the histology report which had analysed what had been removed and provided details of many cancerous nodes. This neither confirmed nor refuted the possibility of something cancerous left behind. But it did reassure me that everything possible was done on the day!
At no point in the pre-ops or the preceding hours could I get a clear answer as to whether further cancer treatment might be needed. That was a shade unsettling and on discharge from hospital "Adjuvant" (= follow-up) chemotherapy was fleetingly mentioned. At this stage I had not seen an Oncologist at any time. After 3 months recovery I had a Face to Face meeting with an Oncologist's Registrar and a few days later started adjuvant chemo, as a precaution. This was in May 20 when Covid lockdowns had started.
I struggled with the chemo; not everyone finds it too bad - but it was tough going for me. I completed 6 cycles and was developing neuropathy in my feet, so the Senior Oncologist discussed options with me, including continue chemo or stop. I was prepared to continue, but was over-ruled - a scan was showing nothing untoward and the judgement was that the risk of increased neuropathy (very bad for diabetic folks) along with my poor tolerance of the chemo cocktail meant stop and review in a few months time.
I remain in remission from cancer. No signs of any sort.
As confirmed by
@rebrascora, T3c is diabetes caused by damage to the pancreas, including damage from scheduled surgery. In % terms it is rare. T2 leads the way for c.90% of all Ds in UK, T1 for c.10% and T3c is miniscule; many medical professionals have not even heard of T3c Diabetes.
BUT it seems that currently you barely have Diabetes. Your daily tests seem to be showing your blood glucose is OK, perhaps just a little high for a non-diabetic person (but fine for someone with diabetes). You should have had a blood test known as an HbA1c, which measures your body's ability to remove glucose from your blood over a 3 month period and I would be amazed if you don't have this test before your next assessment. That will ultimately determine whether you are now formally diabetic and what, if any, medication is appropriate at that time.
If this does result in you being declared diabetic, CLING to a diagnosis of T3c. Regardless of whatever medication is started. The Type of Diabetes diagnosed arises solely from what caused it, not what treatment is needed. You might be started on oral medications as if T2 [but not actually T2] or insulin as if T1 [but not T1]. The importance of this is because T1s (and T3s should) come under Specialist Hospital based Teams, who understand the potential complexities of T1 and T3. Whereas T2s come under GP surgeries, because it is considered within the scope of General Practice; this doesn't make this perfect or even half correct, but is defined by the NICE Guidance for treatment of Diabetes.
T3c might be routine for you initially and might even remain that way in perpetuity. But a damaged pancreas can be a fickle organ and if problems should occur over time, they need taking to an Endocrinologist promptly and not sit with an overworked GP who won't necessarily "join the dots" quickly. This is not a criticism of GPs in general; T3 (any flavour from a-k) will normally be outside the scope of General Practice. Once introduced (referred) to Specialist Diabetes Teams the door is generally open for a patient to ask for help directly, without a new referral.
In my non-medical opinion - possibly. But that could also mean constraining your diet and lifestyle too much. A logical progression might be oral meds to improve your bod'ys ability to manage the insulin you are making, or stronger oral meds to encourage your pancreas to produce more insulin. If you ultimately need insulin it is a nuisance, but not so much of a nuisance. You are recovering from treatment for Pancreatic Cancer and if that means some adjustments for your future quality of life .... I suggest "go with the flow".
I also was very active formerly and am again now. I have had a series of hiccups along the way, including an incisional hernia repair in May this year from my original Whipple Procedure and a month later emergency surgery to unblock my colon, snagged on scar tissue from my original Whipple. Scar tissue is mentioned on my Jan 20 pre-op risks paperwork, but so was death and for some reason I barely noticed the scar tissue "risk"!
I wish you the best of luck with all of this. Right now, take it easy and maximise your recovery from surgery.
Edited to add you should expect to be under the joint care of at least an Oncologist and the HPB surgical team for several months, maybe a year. As well as possibly an Endocrinologist, depending on your future HbA1c result in a couple of months. In theory they should all be well informed about your progress and any changes you might experience. This has not been my experience and I've been proactive in keeping each informed of any development. My GP receives their guidance and writes the necessary prescriptions, but is reactive after NOT proactive before.
