Hello to everyone, that's to the admin team and all members of this much needed support highway!

[Jacko1591]

Good morning to everyone.
I am as of this morning an official type 1 and began my first self injecting this morning. I have migrated from pre-diabetic in early 2019 to type 2 in May 2019. I was fortunate enough to access a DESMOND course within a couple of weeks which was my first real eye opener to healthy and less healthy foods and drinks. I have tried religiously to include that first knowledge within my daily food choices, but of course, that's great when eating at home but eating out it is often pure guesswork or don't join in at all with family and friends. Moving forward, are there any groups that meet up occasionally in Stafford ? Looking forward to gaining more knowledge and tips through this forum group. Hope you all have a positive day. Graham

 

[Alan44]

Good morning @Jacko1591 (Graham) sorry that you've jumped into T1 but I'm sure many T1,s will be able to offer help and advice and be able to answer any questions you may have.

Hope you have a good day

Take care
Alan

 

[gail2]

Hello and welcome to the forum
Feel free to post as much or as little as you like
Its a great site full of support
No question to large/small or to silly
Gail

 

[rebrascora]

Hi. Looking back through your previous posts it appears that you are Type 3c due to damage to your pancreas from Pancreatitis. You may be treated as Type 1 with insulin and hopefully a sensor which gives you constant information (a CGM) about your Blood Glucose (BG) levels but diabetes type is defined by cause and it sounds like the cause of your diabetes is Pancreatitis, which makes you Type 3c.

Who is in charge of supporting you with your diabetes management? Do you attend a hospital diabetes clinic with Diabetes Specialist Nurses (DSNs) and a consultant or are you being treated at your GP practice perhaps by a nurse who has been given a bit of extra training to manage the diabetic patients within the practice?

Are you comfortable telling us which insulin's you are using and if you have a Libre or Dexcom Constant Glucose Monitor?

 

[Jacko1591]

Good morning @Jacko1591 (Graham) sorry that you've jumped into T1 but I'm sure many T1,s will be able to offer help and advice and be able to answer any questions you may have.

Hope you have a good day

Take care
Alan

Thank you very much Alan, much appreciated. kind regards. Graham

 

[Jacko1591]

Hello and welcome to the forum
Feel free to post as much or as little as you like
Its a great site full of support
No question to large/small or to silly
Gail

Hi Gail2,
thank you for the welcome and input, much appreciated.
I always said to friends, social and former work associates that if you ask a question, the likelihood is, all those others around who wanted to ask but weren't confident about doing so will also gain from the answer. I feel sure I will embrace the opportunity of this group.

regards
Graham

 

[Jacko1591]

Hi. Looking back through your previous posts it appears that you are Type 3c due to damage to your pancreas from Pancreatitis. You may be treated as Type 1 with insulin and hopefully a sensor which gives you constant information (a CGM) about your Blood Glucose (BG) levels but diabetes type is defined by cause and it sounds like the cause of your diabetes is Pancreatitis, which makes you Type 3c.

Who is in charge of supporting you with your diabetes management? Do you attend a hospital diabetes clinic with Diabetes Specialist Nurses (DSNs) and a consultant or are you being treated at your GP practice perhaps by a nurse who has been given a bit of extra training to manage the diabetic patients within the practice?

Are you comfortable telling us which insulin's you are using and if you have a Libre or Dexcom Constant Glucose Monitor?

Hi, yes, you are correct about my Pancreas issues.
I am fully managed now under a diabetic consultant and specialist diabetic nurse ( SDN ) with whom I have weekly phone calls and face to face frequently as the pattern of needs have changed.

I have been considering a Libre type system which my SDN has agreed to help with should I move to that BS monitoring method. The insulin that I am on is: Novomix 30

Thank you for your input and questions.

Regards
Graham

 

[HayleyR]

Hello @Jacko1591 and a very warm welcome from me 🙂 . I'm with you on the eating out as on occasion it's just so difficult to judge how many carbs you're going to eat so sometimes I just have to guestimate; certainly don't want to miss out on social gathering with family and friends! This is where the sensor is so helpful as you can see what's happening to your levels with continuous monitoring and take appropriate action if necessary. I've been using the Libre 2 sensor for some time now and for me personally it's been a game changer! Bye for now

 

[Jacko1591]

Hello @Jacko1591 and a very warm welcome from me 🙂 . I'm with you on the eating out as on occasion it's just so difficult to judge how many carbs you're going to eat so sometimes I just have to guestimate; certainly don't want to miss out on social gathering with family and friends! This is where the sensor is so helpful as you can see what's happening to your levels with continuous monitoring and take appropriate action if necessary. I've been using the Libre 2 sensor for some time now and for me personally it's been a game changer! Bye for now

Good evening HayleyR, and thank you for your welcome.

Thank you also for the information surrounding your experience of the Libre system. It is certainly on my radar and will be investigating the various options along with my Specialist Diabetic Nurse in the very future.

I have received so much positive input from you and the other members who responded to my message this morning.

Best wishes and look forward to being more active myself within the this positive thoughtful group.

Graham

 

[everydayupsanddowns]

Hello @Jacko1591

Hopefully if you’ve been confirmed as T1/T3c you’ll be moved to a basal:bolus multiple daily injection (MDI) insulin regimen soon. Mixed insulins aren’t recommended for T1s any more except in special circumstances, because they can be a little inflexible and hard to adjust and tweak. Once a mixed dose is in its IN, and you have to eat the carbs it expects (and only those) whenever it expects them.

With MDI you separate out the background insulin coverage from the meal/snack doses. Which does mean more injections per day, but it means you can eat at your own schedule, and have larger or smaller meals - or skip meals entirely depending on how your day plays out. You can also make adjustments for activity/exercise to reduce the risk of hypos.

Let us know how you get on with Libre 2+ when you get it 🙂

 

[Jacko1591]

Hello @Jacko1591

Hopefully if you’ve been confirmed as T1/T3c you’ll be moved to a basal:bolus multiple daily injection (MDI) insulin regimen soon. Mixed insulins aren’t recommended for T1s any more except in special circumstances, because they can be a little inflexible and hard to adjust and tweak. Once a mixed dose is in its IN, and you have to eat the carbs it expects (and only those) whenever it expects them.

With MDI you separate out the background insulin coverage from the meal/snack doses. Which does mean more injections per day, but it means you can eat at your own schedule, and have larger or smaller meals - or skip meals entirely depending on how your day plays out. You can also make adjustments for activity/exercise to reduce the risk of hypos.

Let us know how you get on with Libre 2+ when you get it 🙂

Good morning everydayupsanddowns,

Thank you for the message which I appreciate.

I will let you know as and when I enter the realms of a Libre type system and my take on it.

regards

Graham ( Jacko 1591 )

 

[helli]

It's great that you now have the correct diagnosis.
The correct treatment - Libre and basal-bolus insulin - should hopefully follow which will give you much more flexibility and make your diabetes easier to manage.
Don't forget to update your "Relationship to Diabetes" on this forum 🙂
We can't change your prescription but the advice you get may vary.

 

[Jacko1591]

It's great that you now have the correct diagnosis.
The correct treatment - Libre and basal-bolus insulin - should hopefully follow which will give you much more flexibility and make your diabetes easier to manage.
Don't forget to update your "Relationship to Diabetes" on this forum 🙂
We can't change your prescription but the advice you get may vary.

Thank you Helli, much appreciated.

Graham

 

[Proud to be erratic]

Hello Graham @Jacko1591. As others have said if your team offer you a Multiple Daily Insulin (MDI) bolus/basal regime don't feel this will make your diabetic life more complicated. On the surface that might seem so, but in practice it should allow you to return to a flexible lifestyle with better blood glucose management.

Also, on the surface it might seem fairly irrelevant to you whether you are formally diagnosed as T1 or T3c. Both require an insulin based treatment and both should provide you with the option of having CGM, such as Libre 2+ or Dexcom One+. However just a small scratch below that surface should reveal significant differences. People with T1 have that diagnosis because of a fundamental autoimmune condition that has destroyed their insulin making capacity. Indeed the autoimmune condition is at the centre of T1 diagnosis parameters. Those diagnosed T3c are in that discrete category because of other pancreatic damage, such as pancreatitis. T3c is currently in a categorisation of Secondary diabetes (T1, T2, Gestational, Secondary). That other damage, from a different but specific ailment, often needs that ailment (pancreatitis in your case) to not only need continuing treatment, but sometimes taking priority over your diabetes. At the very least, most T3cs will usually be managing 2 potentially conflicting ailments: what brought them to T3c and now the diabetes.

It is still, unfortunately, a reality that many Health Care Professionals (HCPs) have never heard of T3c and certainly don't appreciate that it is different to T1. On the plus side it does make them ask and then I can explain. I have found it necessary to reinforce that my D is different, both within my GP Surgery, after GP changes and when I ended up in hospital needing emergency surgery for a blocked colon. I am a retired Civil Engineer, so I don't feel too daunted by the numbers that come with the diabetes territory; also I have approached my diagnosis as if it is just another complex engineering challenge. This has helped me take ownership of my D and in owning it I can manage it my way and defend/ explain/ justify why I routinely do what I do in my ongoing BG management.

I am at the more extreme end of a T3c diagnosis. Others find they can embrace and absorb their diagnosis and consequent treatment plan with some adjustments then minimal fuss. Tagging @Wendal who is one of those, and in our age group. There are several T3cs on this forum.

Good luck with it all.

 

[Jacko1591]

Hello Graham @Jacko1591. As others have said if your team offer you a Multiple Daily Insulin (MDI) bolus/basal regime don't feel this will make your diabetic life more complicated. On the surface that might seem so, but in practice it should allow you to return to a flexible lifestyle with better blood glucose management.

Also, on the surface it might seem fairly irrelevant to you whether you are formally diagnosed as T1 or T3c. Both require an insulin based treatment and both should provide you with the option of having CGM, such as Libre 2+ or Dexcom One+. However just a small scratch below that surface should reveal significant differences. People with T1 have that diagnosis because of a fundamental autoimmune condition that has destroyed their insulin making capacity. Indeed the autoimmune condition is at the centre of T1 diagnosis parameters. Those diagnosed T3c are in that discrete category because of other pancreatic damage, such as pancreatitis. T3c is currently in a categorisation of Secondary diabetes (T1, T2, Gestational, Secondary). That other damage, from a different but specific ailment, often needs that ailment (pancreatitis in your case) to not only need continuing treatment, but sometimes taking priority over your diabetes. At the very least, most T3cs will usually be managing 2 potentially conflicting ailments: what brought them to T3c and now the diabetes.

It is still, unfortunately, a reality that many Health Care Professionals (HCPs) have never heard of T3c and certainly don't appreciate that it is different to T1. On the plus side it does make them ask and then I can explain. I have found it necessary to reinforce that my D is different, both within my GP Surgery, after GP changes and when I ended up in hospital needing emergency surgery for a blocked colon. I am a retired Civil Engineer, so I don't feel too daunted by the numbers that come with the diabetes territory; also I have approached my diagnosis as if it is just another complex engineering challenge. This has helped me take ownership of my D and in owning it I can manage it my way and defend/ explain/ justify why I routinely do what I do in my ongoing BG management.

I am at the more extreme end of a T3c diagnosis. Others find they can embrace and absorb their diagnosis and consequent treatment plan with some adjustments then minimal fuss. Tagging @Wendal who is one of those, and in our age group. There are several T3cs on this forum.

Good luck with it all.

Hello and thank you very much for the information. I briefly recall seeing an article about T3c sometime ago but I had only just been diagnosed with T2 at the time. I am seeing my Diabetic Nurse on Monday morning so will discuss it with her.

Thanks again
Graham ( Jacko1591 )

 

[everydayupsanddowns]

Let us know how you get on tomorrow @Jacko1591

Some of our T3cs like @eggyg had a bit of a challenge getting an accurate classification, because T3c is relatively new, and not all that well understood by some HCPs. Forum experience seems to show that it’s always worth getting a tick put in the right box, even if it can be argued that “it won’t make much difference”.

 

[Wendal]

Hello and thank you very much for the information. I briefly recall seeing an article about T3c sometime ago but I had only just been diagnosed with T2 at the time. I am seeing my Diabetic Nurse on Monday morning so will discuss it with her.

Thanks again
Graham ( Jacko1591 )

Hi Graham,
Hope you are doing well and do let us know how you get on today.As Roland says Type 3c is little known amongst much of the medical community and don’t be surprised if they don’t seem to know much about it.
It is important to get the correct diagnosis but you can make a few assumptions that will help you get back on track.
If you have had pancreatic damage and then later develop diabetes some time afterwards (can range from almost immediately to several years) you are extremely likely imo to be Type 3c,
Medication wise you can be put on Metaformin if not too much Beta cell damage you may get away with that or more likely and especially if they think you may be Type 1 they will put you directly on insulin like myself.
They started me off on 2u basal and 2u of bolus for each meal and adjusted it depending on levels of control.
It is important to come down gradually and first few weeks are about you learning how your body responds to the insulin and adjust accordingly.
I found it took me about 5-6 weeks to get in consistently in targeted range and basically found I live a normal life with my Creon and Insulin and eat what I want and adjust my insulin levels or activity etc.
As you said eating out does present its own set of issues but you get used to it and don’t worry if your level of control is not as good as when in your own house.
We are going to Ludlow for 3 days so will be eating out but you do get used to it and important to enjoy your life as well as manage the diabetes.

 

[Jacko1591]

Let us know how you get on tomorrow @Jacko1591

Some of our T3cs like @eggyg had a bit of a challenge getting an accurate classification, because T3c is relatively new, and not all that well understood by some HCPs. Forum experience seems to show that it’s always worth getting a tick put in the right box, even if it can be argued that “it won’t make much difference”.

Good evening, ive had a full on day with hospital hospital appointments which included one with my specialist diabetic nurse. She agrees entirely that I am almost certainly T3c and is fully aware of it and understands it. She will be carrying out weekly reviews and wants me to stay on my insulin regime for the time being, however will be considering the next step re T3c in the near future. I am offline shortly as I have an 8.00am Lymphoedema appointment and need to get some much needed sleep.

Thank you again for all of the knowledge shared and the care shown from you and everyone who have shared information with mutual empathy.

regards
Graham