New diagnosis - pancreatitis

[Edgar]

I had a very severe attack of acute pancreatitis in 2015 followed by a number of small incidents since but the problem is that I now have contracted Type 2 diabetes and my last HBA1C test yesterday was 91! I have been trying to control this by diet, but my GP put me on metformin 500mg twice daily. I am very careful what I eat but it seems the the pancreatitis has damaged my pancreas, and whatever I seem to do, I can't really control the diabetes very well. I don't drink, don't smoke and try to eat healthy. Don't know what else I can do

I am male aged 74. Should I be buying a blood glucose monitor and checking it myself.My GP didn't mention this at all.Could somone recommend a meter and what accessories I need such as number of lancets required as this is all very new to me. Thank you.

 

[Northerner]

I had a very severe attack of acute pancreatitis in 2015 followed by a number of small incidents since but the problem is that I now have contracted Type 2 diabetes and my last HBA1C test yesterday was 91! I have been trying to control this by diet, but my GP put me on metformin 500mg twice daily. I am very careful what I eat but it seems the the pancreatitis has damaged my pancreas, and whatever I seem to do, I can't really control the diabetes very well. I don't drink, don't smoke and try to eat healthy. Don't know what else I can do

I am male aged 74. Should I be buying a blood glucose monitor and checking it myself.My GP didn't mention this at all.Could somone recommend a meter and what accessories I need such as number of lancets required as this is all very new to me. Thank you.

Hi Edgar, welcome to the forum 🙂 Very sorry to hear about the difficulties you are experiencing Diabetes that arises due to pancreatitis can be complex as it can affect your ability to produce insulin, which is needed to help keep your blood sugar levels under control. We do have several members who have experienced a situation similar to yourself, so hopefully they will be along to share their experiences and hopefully be able to offer you some advice.

Using a meter can really help you to understand what foods you tolerate well and what you may need to reduce or replace in your diet. A;lthough a lot of things are generally considered 'healthy' they may not be suitable when you have diabetes. Fruit juice, for example, contains a lot of sugar which will really cause your blood sugar levels to rise.Have a read of Test,Review, Adjust by Alan S to understand how this can be done efficiently and effectively. If your GP or nurse won't prescribe a meter and test strips (you should ask first, explaining your reasons) then the cheapest option we have come across is the SD Codefree Meter which has test strips at around £8 for 50 (High St brands can cost as much as £30 for 50 test strips). Many of our members use this meter and find it to be very good. You need the type that measures in mmol/l and you will also need to buy some lancets.

Please feel free to ask us any questions you may have and we will do our best to help 🙂

 

[Edgar]

Thanks. I have just read an article about Type 3c diabetes and wonder if I have been mis diagnosed. I have made another appointment with my GP to check this out.

 

[Northerner]

Thanks. I have just read an article about Type 3c diabetes and wonder if I have been mis diagnosed. I have made another appointment with my GP to check this out.

Yes, I don't know a great deal about this myself, but I would doubt that, in your situation, you are Type 2, so your treatment regime may differ. Your GP may be unfamiliar with your type as it is quite rare and I know a number of members here have had difficulties obtaining a correct diagnosis and appropriate treatment. If your GP cannot provide the help you need I would ask to be referred to a specialist endocrinologist. Good luck, and please let us know how you get on 🙂

 

[Davein]

Morning Edgar
I too have experienced several serious episodes of pancreatitis in he last few years resulting in the complication of diabetes. I was initially diagnosed and treated with metformin and then gliclazide. I should point out that I was prescribed Creon which is an enzyme substitute after my third attack As you make no mention of this, I would therefore assume your pancreas is not as badly damaged as mine. When I was put on metformin I purchased a meter and test strips (even though the GP said not to bother) and I was able to monitor my blood glucose levels and the metformin helped me to keep generally within the recommended range. A few months ago I had what I thought was a bug and had the snuffles and a bit of abdomen pain ( pain was not similar to the warning pain I suffered at the start of each attack of pancreatitis) this resulted in my BG levels increasing but I believe that is normal for someone with diabetes temporarily. Unfortunately my blood glucose levels kept increasing. So I went to GP showing him the high BG levels I experienced which topped 34 at the peak. I had a HbA1c blood test which came out at 130. I was then prescribed insulin therapy. Had I not decided to self finance a meter and test strips I would not have known about my raised BG levels and that is partly why I would ALWAYS recommend anyone recently diagnosed with T2 to buy a meter and strips if their GP will not prescribe one. It is also vital for helping you control your diet and monitor the effects that foods have on your BG levels. Keeping levels within or close to the recommended levels will help to minimize the possible complications of this condition later on. Your healthcare services should also set up regular check ups with eye clinic, podiatry (feet) and initially you should have 3 monthly HbA1c blood tests to monitor your BG level. Although my diabetes was triggered by regular episodes of pancreatitis, I am still classed as T2. A recent beta cell urine test confirmed that I still produce a reduced amount of insulin. As I have been diagnosed with Autoimmune Pancreatitis, I have been prescribed an emergency supply of controlled drug Pethidine (for pain relief) I'm sure you can vouch for the fact that pancreatitis can be extremely painful. Like you I do not drink alcohol (in fact been teetotal for 40 years) My gallbladder remains clear and I presume you, like me. fall into the small percentage whose pancreatitis cause remains unknown. You have a lot to take in at the moment. My advice to you is take one day at a time and definitely get a meter. Regards Dave

 

[mikeyB]

Hi Edgar, good to see you again. As I said on the pancreatitis forum, when you see your GP you need to ask for referral to a a specialist to at least discuss using insulin. It seems likely that the pancreatitis has destroyed too many beta cells (the insulin producing cells) for any oral medication or diet to work. Because pancreatic diabetes is so rare, I’m sure your GP would agree to such a referral.

Davein’s experience is a good guide to how this plays out. And I agree, getting a meter to show the results to your GP will strengthen your case.

Best of luck🙂

 

[mikeyB]

By the way, Edgar, now you’ve said hello, you could start a thread on the General Forum for any future queries, more folk would see them.

 

[eggyg]

Hi Edgar, welcome to the club no one wants to join! I too am Type 3c due to pancreatitis leading to surgery to remove most of it. After nearly 8 years I have finally been re categorised as type 1 to enable me to access the services us “ weirdos” need. ( that’s an affection term by the way!) As @mikeyB has said, it’s relatively rare and the GPs and DSNs don’t know how to deal with us so you must insist on seeing a specialist. A type 2 medication/ lifestyle regime just won’t cut it. Although initially cutting down on carbs will help until they can sort you. Are you on Creon? Most of us are, it can raise your BGs unfortunately but I certainly couldn’t go about my everyday business ( pardon the pun) without it. Good luck and remember insist on seeing a specialist, I wish I had known this 8 years ago. Elaine.

 

[Edgar]

Thanks for your advice everyone. A have ordered a meter which should arrive this week and I have an appointment with my GP on the 22nd (earliest I could get!) when I will ask him for a referral. All your posts have been very helpful.

 

[Northerner]

Thanks for your advice everyone. A have ordered a meter which should arrive this week and I have an appointment with my GP on the 22nd (earliest I could get!) when I will ask him for a referral. All your posts have been very helpful.

Good to hear @Edgar 🙂 Shame you have to wait so long for the appointment, but I hope it goes well 🙂

 

[Edgar]

Futher to the discussion about whether I might have Type 3C, whan I had my first attack of pancreatitis (2015), I had an ultrasound followed by an MRI scan which showed all my organs to be perfectly clear including my pancreas. Could there have been a gradual change over the years? I don't think my GP would sanction another MRI so are there any other tests that would show any damage to my pancreas?

 

[Davein]

Futher to the discussion about whether I might have Type 3C, whan I had my first attack of pancreatitis (2015), I had an ultrasound followed by an MRI scan which showed all my organs to be perfectly clear including my pancreas. Could there have been a gradual change over the years? I don't think my GP would sanction another MRI so are there any other tests that would show any damage to my pancreas?

Morning Edgar
I have had multiple attacks of pancreatitis and to my knowledge the only way of telling if there's any damage is scans and x rays. I've had a c-peptide test to see what level of beta cells I'm producing which is a simple urine test carried out within a certain time of having a meal. I have had numerous scans and cameras but only after a further episode of pancreatitis. I am still classed as type two even though I now have insulin therapy. If you are being treated with oral medication (metformin) and your BG levels are continuously high it is possible that you may require insulin therapy. I went about 3 years just being treated with oral meds until my last episode then put on insulin. I know there is an argument about T3c's being put straight away on insulin but if your pancreas is still producing sufficient insulin and your BG levels are kept within a reasonable range by oral drugs then that is the treatment most GPs will prescribe I believe, or at least start you on. Whether or not this is purely on cost grounds is debateable.
Hopefully doctor Mike may be along to inform you of any other way of testing for damage.

 

[Edgar]

Thank you🙂

 

[mikeyB]

No need for me to add to anything you’ve said, Davein. A C-Peptide test will show how much insulin the body is producing in response to food. There is an argument for using insulin anyway to give the battered pancreas a holiday rather than hammering it with drugs.