Hello

M

MissyT

New Member
Relationship to Diabetes
Type 1
I am knew to this as I have never 'posted' on a Forum before, however, I have been a Type 1 Diabetic for 30+ years and it started with Gestational Diabetes and unfortunetly didn't go away. That was back in 1994!

I am 63 years old and recently diagnosed with Breast Cancer. I'm having a masectomy and reconstructive surgery (back flap) on 11 October 2024, and I had quite a fight on my hands to convince the breast surgeon to give me reconstructive surgery. All I'm hearing is that the success rate of a successful reconstruction on a T1 Diabetic is poor.

I would really love to hear from any T1 woman who has gone through this procedure and how it went and what their thoughts are now having gone through it. Thank You



,
 
Welcome @MissyT, sorry to hear of everything you have and are still going through. What sort of things have you been hearing to conclude that the success rate is poor? I wonder if this is related to recovery, since the body takes longer to heal when living with diabetes. Of course this is related to your blood sugars - what's your latest HbA1c? :care:
 
Well - have you got a really really good history of pretty instant healing when you've been injured or had a different operation? (eg stitches being difficult to remove cos the shin's healed too well around them, or not needing stitches in really deep cuts)
 
I am new to this forum but have been T1 diabetics for 31 years - I developed gestational diabetes but unfortunately it didn’t go away.
Wondering if anyone has been in my current situation as I’ve been diagnosed with Breast Cancer and having a mastectomy and reconstructive surgery in couple of weeks.
I have had to fight for the reconstruction and all I’m hearing is that failure rate is high due to diabetics being poor healers.
So, if anyone has had any experience of this it would be so great to hear from you - good or bad experience.
Thank you
Marion
 
Hello @MissyT, really sorry you're in this position.

My experience of healing after major surgery, is limited. I had my Whipple in Feb '20 and that healed well, with minimal issue. I had to go back and have that scar reopened in mid '22; the healing after that was much slower; but was that because it was a reopened wound and my D was not a factor?

What struck me about your post was your determination to put matters right, then presumably end a chapter and move on with that behind you. Great attitude. But I wondered what would be the consequences if the reconstruction failed? Presumably more surgery to reverse/reduce the reconstruction which would inevitably be at a time when your body was already fighting to keep you well and your D management was already becoming extra challenging from all the preceding surgical intervention.

I'm not trying to be pessimistic (which it sort of sounds like I am) but is there a brief for what would be needed if the reconstruction failed? I guess there is an element of managing expectations: the mastectomy is a big surgical intervention anyway, do you need to put yourself through further stress and risk in the longer term? Might you be better off taking the immediate win and reward yourself with a potentially simpler outcome?

This is impossible for any outsider to think through for you and yet really stressful for you to consider for yourself. But is this a personal challenge that might be less beneficial than the potential gain? If the reconstruction doesn't work could this chapter drag on for months more? What are the scar tissue outcomes? When I had my Whipple scar tissue was on a list of 9 risks, but seemed irrelevant when that list included death or nor being successful in removing the cancerous tissue; but it was internal scar tissue that caused my blockage in '22 and the necessity to have further major surgical intervention (I was in hospital for 3 wks in mid '22, but only 2 weeks for my Whipple) and certainly lost the rest of '22 to a slower recovery.

Whatever you decide I truly wish you a simple and successful outcome.
 
Hi and welcome.

Really sorry to hear you are in this very worrying situation and I wish you all the luck in the world for the very best outcome. I can totally understand your wish for reconstructive surgery and also the reticence on the part of the medical profession. I think you have to look at this from an individual perspective particularly with diabetes because there are about 90% of people with diabetes who are Type 2 and 10% who are Type 1 and that may be a factor, so I would ask about the stats in that respect. As an insulin dependent diabetic, you have the ability to perhaps manage your diabetes more closely than the average Type 2. If you are really committed to managing it well and have the knowledge and ability to do so and the tech to help you, that may well offset the concerns about healing. The surgery will no doubt push your BG levels up because it is stressful to the body, but with insulin you have the potential ability to balance that and bring it down. Many Type 2s going through the same thing who don't have insulin might have high BG levels for weeks after the surgery and not be able to do much about it and that high BG will impact the healing process.

How do you currently manage your diabetes? Are you on MDI or a pump? What sort of HbA1c do you typically get? I assume you have a Constant Glucose Monitor (CGM) to help you track your levels. I think the efficacy of your diabetes management will make a significant difference to the outcome of your surgery and recovery, so to me that is what you need to focus on. Practice now before the surgery. Learn tips and techniques from this forum to achieve better results so that you are giving your body the optimum chance of healing well after the surgery.

I should say that I have no medical or practical experience of this situation but what makes diabetic patients different from people who do not have diabetes is higher BG levels which provide optimum conditions for bacteria to thrive, so keeping your BG levels as normal as possible after the surgery and during the healing process will give you almost the same chance of success as a non diabetic patient. I hope that makes sense.
 
Hi @MissyT and welcome to the forum! I have taken the liberty off merging your two threads together as you had some answers and questions under the previously posted one as well. <3
 
My post sounds quite abrasive - sorry - but simply if you don't heal well, any surgery is a bigger risk, is all.
 
Anna DUK said:
Welcome @MissyT, sorry to hear of everything you have and are still going through. What sort of things have you been hearing to conclude that the success rate is poor? I wonder if this is related to recovery, since the body takes longer to heal when living with diabetes. Of course this is related to your blood sugars - what's your latest HbA1c? :care:
Click to expand...
55 which my diabetic team say is very good x
 
MissyT said:
55 which my diabetic team say is very good x
Click to expand...
For reference, such as that may be, my Endo says my 56 is very good for me with absolutely no pancreas.
 
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