I am a bit lost now about diet

[lilyb]

It’s been 6 years since I had pancreatic cancer surgery. I had the head of the pancreas removed and my duodenum so have lots of tablets and insulin to take…..I have no appetite as a consequence and struggle to eat!
Would a specific diet help? I alternate cereal and porridge in the mornings start to feel sick and headaches by 11 o’clock so have cheese and crackers or toast with jam, mid afternoon tea and a biscuit or sticky bun occasionally.
tea is horrible because I don’t want food but might have a small individual M&S quiche…..or 2cocktail sausages on their own…hence not too sure where to go and what to do….any suggestions gratefully received. Thank You.

 

[Inka]

Hi @lilyb Sorry to hear you’re struggling with your diet. It sounds like you have Type 3c diabetes? There are others here who’ve had such surgery or similar, including @Proud to be erratic and @soupdragon and @eggyg They might have some advice.

What insulin(s) do you take (full name including any letters or numbers)?

Is the issue the nausea, or do you just have no appetite? Or is it both? Has your surgery placed any limits on your diet eg regarding fibre? How are your blood sugars?

 

[rebrascora]

Hi.
Sorry to hear you are really struggling to eat and enjoy food. Looking back at your previous posts I see that you are/were on Metformin and Gliclazide as well as Humulin S Is this still the situation with your medication?
The Metformin can act as an appetite suppressant and since you are not Type 2 that will not be helping your situation. I also wonder if perhaps you might be deficient in Vitamin B which the issues with your digestive tract and the Metformin could be causing. On top of that, the Gliclazide for someone in your situation ie Type 3c is detrimental I believe, so I would really hope that those 2 medications have been withdrawn from your repeat prescription list as they certainly could be contributing to you feeling unwell. I hope some of the other Type 3c members will be able to offer you some further advice but I really think you should be under the care of a diabetes specialist consultant at your local hospital to get the right support, so do push your GP to make a referral.

 

[lilyb]

Hi @lilyb Sorry to hear you’re struggling with your diet. It sounds like you have Type 3c diabetes? There are others here who’ve had such surgery or similar, including @Proud to be erratic and @soupdragon and @eggyg They might have some advice.

What insulin(s) do you take (full name including any letters or numbers)?

Is the issue the nausea, or do you just have no appetite? Or is it both? Has your surgery placed any limits on your diet eg regarding fibre? How are your blood sugars?

Hello… I am definitely type 3c…..I am on Humilin s and have been told to increase my dosage by 2 units until I could get the blood sugar lower….it’s not helping. The headache comes with nausea several times a week I take some paracetamol and cyclizine and try to sit quietly with my eyes closed for a while.
I haven’t had any appetite since the surgery, nothing wrong with my stools really I try to have a specific cereal at those times….my blood sugars in the mornings are around6-9mmols but the evenings are crazy silly and not because I have had chocolate or anything highly sugary…..I have even cut right down on fruit because of the sugars!
but the evening sugars are regularly high 12-once a 16!

 

[lilyb]

Hi.
Sorry to hear you are really struggling to eat and enjoy food. Looking back at your previous posts I see that you are/were on Metformin and Gliclazide as well as Humulin S Is this still the situation with your medication?
The Metformin can act as an appetite suppressant and since you are not Type 2 that will not be helping your situation. I also wonder if perhaps you might be deficient in Vitamin B which the issues with your digestive tract and the Metformin could be causing. On top of that, the Gliclazide for someone in your situation ie Type 3c is detrimental I believe, so I would really hope that those 2 medications have been withdrawn from your repeat prescription list as they certainly could be contributing to you feeling unwell. I hope some of the other Type 3c members will be able to offer you some further advice but I really think you should be under the care of a diabetes specialist consultant at your local hospital to get the right support, so do push your GP to make a referral.

Enjoyment and food not in the same sentenc, lol, I take metformin bd same with gliclazide but my diabetic nurse is tempted to stop it…I have been taking vitamin b 12 for a few months to see if anything happens.
trying a GP is a lost cause at the moment…but I am expecting a call from the diabetic nurse who has me taking an extra bedtime reading….plus I have a tutorial coming up about using the Libre system.
I agree about the metformin and gliclazide but have to get approval… I was trying to figure if my Creon was adding to my problems…..insert a long sigh here……thank you for the insight.

 

[eggyg]

I wonder if like me ( also Type 3c tail and body removed) you have gastric dumping or some other gastric problem. These ops do a lot of messing about with your innards. Looking at your diet, it’s quite carby, especially simple carbs, jam , sticky buns, cereal and so on. Those will not only keep your BGs high but will ( as they do me) make you feel rubbish. Your body can’t deal with them like a ‘normal’ persons body can. In me it manifests itself in having one of my “turns” as my hubby calls them. I have been known to pass out. I go sweaty, nauseous and have to lie down for about 30/45 minutes. Perhaps try more protein and less carbs and little and often. Your high BGs will make you feel rotten too, it may be worth asking to come off the Glic and go onto a basal/bolus regime. That way you can have more control. As Type 3cs that is the next step after tablets and a mixed insulin. How much Creon do you take per meal? Creon is a funny thing, I’ve been taking it for 15 years and I have just taught myself how to use it. The best piece of advice I was given, not by a doc they don’t have a clue, was take a couple of bites to get your system working then take your Creon. It helped me enormously. Type 3c can be a pain in the backside, sometimes literally it’s very much trial and error. Anything please ask away. Elaine.

 

[Inka]

Hello… I am definitely type 3c…..I am on Humilin s and have been told to increase my dosage by 2 units until I could get the blood sugar lower….it’s not helping. The headache comes with nausea several times a week I take some paracetamol and cyclizine and try to sit quietly with my eyes closed for a while.
I haven’t had any appetite since the surgery, nothing wrong with my stools really I try to have a specific cereal at those times….my blood sugars in the mornings are around6-9mmols but the evenings are crazy silly and not because I have had chocolate or anything highly sugary…..I have even cut right down on fruit because of the sugars!
but the evening sugars are regularly high 12-once a 16!

I agree with @eggyg that you might find a basal/bolus insulin regime gives you better control. That would mean a slow background insulin and a bolus/meal/fast insulin - so two different insulins.

You also say you’re sometimes

 

[rebrascora]

Unfortunately, if your body is unable to absorb Vitamin B then tasking a supplement orally will not help. Unfortunately Metformin is known for preventing absorption and if you are deficient, then you need B12 injections to get it into your system where it needs to be.
I really hope your Diabetic nurse stops the Metformin and Gliclazide. Please do keep raising that issue and as the others have said, the insulin you are currently using is not by any means ideal on it's own. In my opinion you would be better off either with a mixed insulin or ideally a basal/bolus regime, where you inject long acting insulin to cover the glucose released by your liver and short acting insulin to deal with the food you eat. It is more complicated but we can help you with understanding how to use it. Can you ask your nurse if she can do a B12 blood test. Vitamin B is associated with your nerves and nerves control a lot of functions within the body. A combination of low Vitamin B12 and high BG levels could be causing problems with your digestive system as well as the nerves in other parts of your body.

I agree that your diet is not helping your situation. Diabetes is affected by all carbohydrates, not just sweet or sugary stuff, so bread, pasta, rice, potatoes and breakfast cereals and yes fruit and fruit juice and dried fruit will all release glucose into your blood stream and push your levels higher. On a basal/bolus insulin system you would learn to balance the amount of insulin to the foods you choose to eat but I am not sure how you would use Humulin S to manage things on it's own.