Welcome
@Type3G to the Forum. Also welcome to a very small and yet very varied diabetes Type. To put this in perspective Type1 diabetes is some 10% of those diagnosed in UK, almost 90% are Type 2 and the rest (all other Types) perhaps 1-2%. Within we Type 3cs, just part of that 1-2%, some people manage their elevated BG by diet and lifestyle only, some (such as yourself) by relatively fixed doses of a mixed insulin once or even twice daily; and some of us with full blown multiple daily injections (MDI).
I joined the T3c club after a total pancreatectomy, necessary to "treat" my pancreatic cancer (PC). So my entrance path has very little resemblance to your pancreatitis route and I have no comparable experience to your symptoms. However I can strongly empathise with your initial experience of managing your rapidly changing BG shortly after starting on insulin. I spent too long bouncing from hyper to hypo (the diabetes roller coaster) with far too little understanding of what was causing what and thus how to get off the roller coaster. It is not easy, BUT can be done. I think this can be compared to "eating the elephant - one bite at a time"
Hello,
I have type 3c from pancreatic damage (gallstones), not alcohol, diet or smoking. Managed with Humulin i. 10 units Am, 10 units Pm.
Here on the forum the majority of our T3cs got here after pancreatitis. Whether gallstones or other ways, the outcome is usually an ill-quantified degree of damage to our pancreas. This can be just to the insulin hormone production; usually also to our digestive enzymes. Possibly due to our ability to produce the hormone Glucagon, which is fundamental to our internal ability to counter too much insulin; Glucagon is sent by our brain to instruct the liver to open its glucose store, when our brain has detected we are going low. Also possibly damage to that bit of the pancreas that creates the hormone somostatin, which provides a degree of auto regulation between insulin and glucose levels.
So, while the pancreas is itself a small organism it plays a massive part in our metabolism, hour by hour 24 hrs a day. We have to manage some or all of those functions for ourselves.
For the past 14 days or so I’ve been swinging on my readings a lot. I’ve had hypos, including quite a severe one and hypers. I’m worried my current regime isn’t suitable.
In my case I know all my pancreatic functions don't exist, whereas for you there is fundamental uncertainty about what your pancreas is able to do AND the real possibility that some of those pancreatic hormones and enzymes play intermittently. That can make your BG behaviour even more varied and unpredictable.
The remark earlier by
@Inka about digestion is extremely pertinent (thank you Inka for tagging me). It could be on a better day you get full digestion and thus the benefit of carbs eaten, but poor digestion at another time. Are you on a Pancreatic Enzyme Replacement Therapy (PERT) medication, such as Creon?
This leads me into asking who is overseeing your pancreatitis, a Consultant or your GP? Do you have ready access to that person or at the Hospital a Diabetes Specialist Nurse (DSN), who should have a reasonable degree of understanding of your BG behaviour. I say should, but remember Type 3c is not widely encountered in relation to other Diabetes Types; so you might encounter even DSNs who will know the theory but might have little actual experience of T3c from pancreatitis.
I went very low on Monday (very rapidly) and nearly had an admission hypo.
It would be helpful to know a little more about this event.
Was it an isolated event in the last 2 weeks? How did you know you were low - from a finger prick and test meter, from CGM, or from how you felt?
Indeed do you have CGM, such as Libre 2+ or Dexcom One+? If not is this going to be provided? If not has it been discussed. Since you take insulin twice daily you should be eligible.
If you experienced actual hypo symptoms, were these confirmed by a finger prick (fp) test. It is sometimes possible to experience a false hypo, when your body is falsely flagging up those hypo symptoms but has been misled by a rapid change of BG levels
Yesterday I ate my lunch - a usual lunch, nothing different - but my blood sugar went up to 17. I am waking up in the morning with my blood sugar at 8.5-10.
As said above there is a lot going on for you. Your high of 17 is a bit challenging at 1st glance; but if your BG returned to more normal levels during the afternoon then that challenge is more a question of timing. Since you only have your mixed Humulin I twice daily, your lunch doesn't have the immediate benefit of insulin to help. I'll return to this thought shortly.
Again, a lot can be interpreted if you already have a CGM, by scrutiny of your CGM graphs. If you don't have CGM already this BG volatility would add great weight to your justification for needing CGM and for your Consultant or GP to support the business case for the NHS paying for that.
I feel dreadful. I am having a bout of pancreatitis as well which complicates things.
Other than knowing that a bout of pancreatitis is painful and debilitating, it is outside of my experience I don't even know if such bouts last for hours or days. But I do know that medical stress plays havoc with BG levels and that alone can explain BG variability, sometimes in advance of the ailment symptoms actually occurring.
Do I need to adjust my insulin, seek another treatment or wait it out? I wonder about a short acting insulin. I feel totally lost and I’m losing motivation to seek or fight for treatment.
Thanks in advance
We can't give medical advice. But right now it seems to me that you need to reach out to your Consultant or GP for further help. ALSO for a CGM if you don't already have this; daily monitoring in conjunction with good use of Alarms or Alerts could make a big dent in your current BG volatility.
My instinct is that you might be better with MDI, ie both the slow acting basal insulin for your background BG behaviour and fast acting bolus insulin for each meal or snack, as well as the opportunity to make corrections when unduly high.
To help manage your short term expectations, regardless of what others can achieve with their BG management, in your unique initial circumstances if you can stay between 5-12 mmol/L readings you will be both safe and reasonably comfortable in how you are feeling (outside of problems and pain from a bout of pancreatitis). It is very early days for your new diabetic status.
There is a lot of uncertainty about how your pancreas is working today and could be changing thanks to further pancreatitis bouts.
You need time for trial and learning about you, your body's ways of exhibiting BG symptoms, as well as about your use of mixed insulin (or MDI).
There is huge amount to learn about managing your D in general. You might find Gary Scheiner's book "Think Like a Pancreas" useful to get a better understanding of how one's pancreas works. One thing Scheiner says to his readers early on in the book: "Diabetes is Confusing, Complicated and Contradictory". I think you are seeing each of those challengess for yourself.
Tagging
@sololite who has seen his pancreatitis transition to needing a full pancreatectomy recently; and
@stackingcups, amongst several other who are T3c from pancreatitis.
There are several more T3c members. If you added T3c to the end of your post title, this may help catch their attention to allow them to offer their insights and experience. Do keep us informed and asking questions. This is not easy! But is manageable.
