Confused about situation

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Anxious 63 said:
Thanks soupdragon for replying i can identify wqith alot of your problems , i had my gall bladder removed 16 years ago which also caused mild pancreatitis , but last winter when i had my acute attack of pancreatitis i also had pneumonia i was in a terrible state in hospital for 3 months , i still have problems eating so i too have soup and light stuff under a new team now at Manchester Royal with specialist HPB team, hopefully they might have some answers , i think im going to end up i on insulin vey soon. thanks for your message and summary , i will keep you updated thanks
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Glad to hear you're under a specialist team and hope things start to improve soon.
 
so spoke with diabetes team and they said peptide test was in range but low it was 850 but should have been higher , so they want me on insulin long acting and a daily dose too with food, so they will contact gp and he sends insulin to chemist then i phone up for another appointment at MRI , also received telephone appointment for next wed with hepto billary consultant which i am trying to change to face to face
 
Good to hear they are starting you on a basal/bolus insulin regime. If you have any questions or concerns once you get started on it, do come here and ask.
Good luck getting a face to face upgrade for your appointment next Wed.
 
Anxious 63 said:
so spoke with diabetes team and they said peptide test was in range but low it was 850 but should have been higher , so they want me on insulin long acting and a daily dose too with food, so they will contact gp and he sends insulin to chemist then i phone up for another appointment at MRI , also received telephone appointment for next wed with hepto billary consultant which i am trying to change to face to face
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Glad to hear that you've got appointments with the diabetes and HPB team and hope you manage to get a face to face appointment.
Basal/bolus should make things much easier in the long term.
Do let us know if we can help once you get started on insulin.
 
Thanks soupdragon ive just phoned the consultants secretary and requested a face to face appointment hopefully i wqill receive this , as i mentioned about the blood sugars they are still high but i think i may have some infection and feel very anxious so i was wondering if that is the case then my blood sugar would go up naturally and maybe the insulin might not be needed , just wondered if you or anybody as thoughts on this , or does it not matter if you BS is still high one might still need insulin , one thing for sure the gliclazide is not bringing it down
 
If the Glic is not bringing it down then your pancreas is unable to produce enough insulin to balance your levels, whether those high levels are caused by illness, infection, food or anxiety. You need to inject insulin to help your body do that and continuing to use Glic is just like "flogging a dying horse" It isn't going to work for much longer, so the sooner you introduce insulin and give your remaining pancreatic function a rest, the better chance of preserving what little ability to produce insulin it has left. This means that you will need smaller doses of insulin initially just to help out.
 
Anxious 63 said:
Thanks soupdragon ive just phoned the consultants secretary and requested a face to face appointment hopefully i wqill receive this , as i mentioned about the blood sugars they are still high but i think i may have some infection and feel very anxious so i was wondering if that is the case then my blood sugar would go up naturally and maybe the insulin might not be needed , just wondered if you or anybody as thoughts on this , or does it not matter if you BS is still high one might still need insulin , one thing for sure the gliclazide is not bringing it down
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With the amount of pancreatic damage you have it sounds as though insulin will be needed, especially if gliclazide is not helping to bring your glucose levels down. As @rebrascora has mentioned, starting insulin now may preserve some of your own insulin production, which will help with your diabetes management in the future.
 
Anxious 63 said:
cheers guys the secretary just confirmed it will be a face to face meeting next wed , so i am relieved about that , i should maybe get the insulin started next week too , dealing with 2 different teams is a bit of farce though
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Yes, dealing with multiple 'specialists' has its challenges. I guess, but I could be wrong, that HPB will step back (their work is done post surgery, they may monitor for a while yet though - mine did) and defer to your Endocrinologist team - which is where your future lies!
Are the 2 teams in the same hospital, or at least the same Trust? Do you have a dietician you can turn to, if needed? My HPB and Diabetes teams now share the same dietician - which is fortuitous.

Anyway good luck for next Wed. Write a list of questions in advance; it's too easy to forget on the day and getting a 2nd bite of the cherry is difficult.
 
does anybody know what the blood peptide test for insulin levels is , the nurse said that mine was 850 he said your pancreas is producing some insulin but not enough , i think the range is between300 and 3500
 
Anxious 63 said:
does anybody know what the blood peptide test for insulin levels is , the nurse said that mine was 850 he said your pancreas is producing some insulin but not enough , i think the range is between300 and 3500
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It is one of the tests used to diagnose Type 1 diabetes. The c-peptide test but GAD antibodies is the other one.
I assume he meant that you are still producing some insulin but not enough which means that you may need additional medication, maybe insulin to help you cope with carbohydrates in your diet. Did he advise anything about diet?
 
thanks leading lights they did mention diet but they were more concerned about the recent high BS and were concerned about gliclazide not reducing the BS . they have come to the conclusion that my damaged pancreas is responsible for endocrine and exocrine pancreatic insuffiency
 
It's late and I might be misinterpreting what you've just said:
Anxious 63 said:
thanks leading lights they did mention diet but they were more concerned about the recent high BS and were concerned about gliclazide not reducing the BS .
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That makes sense; your test shows you're not producing enough insulin, so you need to be getting insulin - whereas the Glic is "flogging" your pancreas which already can't cope.
Anxious 63 said:
they have come to the conclusion that my damaged pancreas is responsible for endocrine and exocrine pancreatic insuffiency
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That, I thought, was already established hence your need for Creon to assist your digestion and thus metabolism. But, important as this aspect is, its a distraction. If you are currently not metabolising all the carbs you eat, then you will need even more insulin when you do fully digest and metabolise all carbs.

The important point should be to get you started on a basal / bolus insulin regime as soon as possible, to protect your residual panc'y - and (in my NON medical opinion) get you off the Glic. What is the outcome for that process?

Perhaps I've misunderstood. Which Consultant did you see yesterday?
 
HI there erractic not its this coming wed that i see both the consultant hepto /billary then later the diabetes team who are starting me on the insulin , i wqould have thought it wqould be the doctors who would decide about the insulin, i will try to find out more on wed
 
Anxious 63 said:
HI there erractic not its this coming wed that i see both the consultant hepto /billary then later the diabetes team who are starting me on the insulin , i wqould have thought it wqould be the doctors who would decide about the insulin, i will try to find out more on wed
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Got it, thanks; apologies for misunderstanding.

Do not 'fear' the consequences of starting insulun; it might seem daunting, but should bring you welcome relief and better BG stability - better, but not perfect; perfection is not realistic, even with the great advances in D management from new technology. I guess, that starting on insulin will bring some relief fairly quickly - yet probably shouldn't be rushed. If your body has got used to constant high BG then it will need time to adjust to more normal levels. I suggest you might add this aspect to your list of questions or discussion points.

Reading back last night, I deduce that the constipation feels like your immediate problem - and if so I get that; it's no fun being constipated! I have this sometimes and get Fybogel sachets on prescription; they work well for me. I recall @rebrascora having her own home mix 'fix', which (if I recall correctly) broadly mimics Fybogel sachet contents.

I also eat prunes and dates to help me; but I can do this readily by taking extra insulin to counter the extra carbs that any dried fruit always contains.

I realise your current diet creates its own challenges - and again I understand this becomes an immediate problem. Then, if your BG is regularly high, that alone will make you feel well below par and add to your overall 'poorly' feeling. All of that possibly being made worse, certainly more complicated, by your prescribed cocktail of medications, with their various side-effects.

Good luck for next Wednesday.
 
went to hospital today did not see consultant but seen his no 2 and pancreatic nurses , basically they said my pancreas took a big hit last winter and now i am a bit like what they call a type 3 diabetic , they changed a few tablets round and put me on insulin , gave the number and said if you very ill i.e. vomiting etc phone and come to a/e , later went to diabetic centre and the nurse show me how to us the insulin 10 units of long acting and 4 units of short acting when i eat , i told them i have not been eating much recently and they insisted on taking Creon , i found it all very stressful and although i have moved on a bit i am very anxious about the whole procedure and a very uncertain future, my mental state is all-over the show
 
Continuing on from the the wed hospital visits they put on a note brittle diagnosis which i looked up and i dont think they now have me as type 2 now , the stuff they gave me to do the insulin shots i am finding difficult they did show me but i dont think i am doing it right im not sure the insulin is actually going in as daft as it sounds , 10 for long acting and 4 with each meal but im not eating much anyway , it sounds daft but im ver anxious anyway and this just making me worse , i have phoned the diabetic centre at manchester royal anyway hope they get back to me today
 
What makes you think the insulin isn’t going in? There will be lots of videos on YouTube showing how to inject insulin if you need a refresher
 
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