Thanks for your concern will try that
Hello
@Anxious 63 , sorry to hear you are in such difficulty.
@rebrascora tagged me, I'm T3c following a total pancreatectomy for pancreatic cancer, so I know something about the diabetes perspective, but not very much about pancreatitis - I escaped that bit! I'm not familiar with the detailed effects of Metformin or Gliclazide; but I agree with the logic that taking oral meds that make a damaged pancreas work harder is akin to flogging a dead horse. Insulin, usually by injection, gives respite to an ailing pancreas and my non medical opinion is that insulin should be prescribed to replace, not supplement, the oral meds that stress the pancreas.
You are in an unusual position, needing specialist care for both diabetes and pancreatitis. If you are fortunate enough to come under a Hospital that manages both conditions within the same Department - brilliant. But sometimes these conditions are treated slightly separately and then conflicting advice can occur. I suspect the Nurse that switched you onto Gliclazide was focussed on your apparent T2 diagnosis and not on the pancreatitis that could well mean you are actually T3c.
If that seems like splitting hairs, the type of diabetes is defined by the cause, not the treatment. T1s have an autoimmune deficiency that prevents their bodies from producing their own insulin; hence insulin on prescription. T2s have an abnormally high resistance to insulin; they produce it but their bodies don't manage it well, hence oral meds to get the pancreas to produce even more insulin; then some T2s eventually need insulin injections. T3s, various flavours from a-h, are people whose pancreas has become damaged - mine from its removal, yours from pancreatitis, other for all sorts of reasons - and T3s need insulin from a medical solution, oral or injections. You were categorised as T2 to put you in a category that made prescribing oral meds possible, but that is simplistic and initially excludes you from a prescription of insulin by injection. If you'd been discharged as a T3c that should have kept the full spectrum of diabetes treatment open to you.
About elevated BG:
In the short term 12s and 14s are not ideal, but far from serious if temporary, even if for a few days. In the long term, over weeks and months high BG can lead to permanent damage to the smallest blood vessels and thus organs and extremities. But at 12-14 you are a very long way from that just now, and I would be more concerned if you were at least above 15, when ketones can come into play and become a different problem, or in the 20s - essentially a 'don't go there' (or not for long!) zone for most of us.
One other thing to keep in mind is that there are very many factors that can affect Blood Glucose in diabetic people. Currently 42 factors, but probably still counting. A few are obscure and not relevant right now. A couple are very obvious: the amount of carbohydrates eaten and the availability of insulin to one's body to deal with the glucose from digestion of those carbs. Full hydration is important, (see below). Stress elevates BG and stress embraces:
the daily events that make one angry, upset or anxious;
medical ailments that cause the body to fight those ailments;
and emotions, such as watching a horror movie or a TV thriller.
You've had a tooth infection; that would be likely to raise your BG, as possibly would any antibiotics. You are constipated and that is enduringly stressful and you've said you are anxious - perfectly normal (so would I be).
So anything you can do to de-stress yourself will always be beneficial; easy said, I know, but worth remembering and trying to do. There are a number of relaxation techniques that can be found on the internet; I've recently tried Mindfulness, which I originally dismissed as namby-pamby stuff for others but not me and I now admit I was wrong; it works for me!
About hydration:
For years my GP had been telling me after blood tests that I wasn't drinking enough water. Now, because of the diabetes and that I have the Libre 2 sensor with an app that provides continuous glucose monitoring, I can promptly see the benefit in reducing my BG after drinking a large glass of water. The higher your BG the more your body tries to offload the excess glucose, by urinating. That, as a natural consequence starts to dehydrate you and at the same time increasing the concentration of glucose in your blood stream. Catch 22. I can only advise you to drink lots (and lots) of water or decaffeinated liquids; normal tea and coffee make dehydration worse - unfortunately, because I love my frothy coffee! Staying fully hydrated will help lower your BG.
If a medication that should help you pass more water isn't working, I'm afraid the obvious conclusion is that you aren't drinking enough water! Drink enough and that should resolve itself. Unless there is a blockage from something like your prostrate, which is initially an Urgent GP appointment matter. Or a trip to A&E. There are non-invasive ways of diagnosing this and moderately simple ways of emptying an over full bladder, eg a catheter.
About Creon:
Creon is a Pancreatic Enzyme Replacement Treatment (PERT). I have been assured by my original surgeon in Oxford, 3 different Endocrinologists, a Gastroenterologist and a singularly competent dietician that you can not take too much Creon! I was recently described as taking it in industrial quantities and I had steadily increased my dosage until my stools had a normal shape and colour and the output was not unduly offensive. The important thing was to try and ensure I was fully digesting all that I ate and that counted carbs taken in ended up in my blood as glucose. Malabsorption was confusing the carb counting and insulin dosing.
Now I'm through that phase I'm just very gradually reducing my Creon capsules. Very roughly I take 1 capsule for every 10gms of carbohydrate, although there is
NO mathematical relationship between Creon and carbs. It is just a simplistic way that I use to guestimate how many capsules per meal. I am an omnivore and fortunate enough to be at an ideal weight, so my diet is high in carbs, proteins and fats.
I also take Omeprazole, 2x daily, which is a Proton Pump Inhibitor (PPI) that reduces my natural stomach acid. I had understood this is a medication frequently prescribed in connection with pancreatitis.
Conclusion:
After digesting all of this ramble, you might want to consider not waiting until an undefined date in April for a Pancreatitis consult but seeking an URGENT diabetes referral with an Endocrinologist, for your diabetes, specifically to confirm that you aren't actually T2 but T3c, with a Pancreas damaged by pancreatitis and that oral medications such as Gliclazide aren't appropriate. You possibly can do this by speaking again with your DSN who changed you onto Gliclazide; or by going back to your GP and asking for that Urgent referral. You can also ask your GP to prescribe a decent laxative.
I hope some of this helps.
