Had T3c confirmed the other day after CT scan showed no further complications since last surgery in '22.
Hello
@djdave and welcome. I'm also T3c but I had to surrender my panc'y completely to qualify for this select club.
Yes 7x25k Creon per meal.
No doubt someone initially guided you towards this dose level for Creon. You might find it helpful to know that firstly you can't overdose on Creon; I understand that the very worst that you might encounter from too much Creon is loose stools. The other thing is that with Creon in particular you need what you need; I like a coffee with double cream and that needs 1x 25k capsule on its own.
A Gastroenterologist lightheartedly described my Creon consumption as in industrial quantities; I get through a tub of 100 x 25k capsules in 3 days. That is not the biggest consumption recorded on thus forum, so far. So don't feel constrained: if you need more Creon, so be it. Having the right amount of Creon is for me a vital part of not just being comfortable with daily routines, but noticeably assists with carb counting - confidence about full digestion of counted carbs allows me to feel confident about carb : insulin ratios for bolus dosing.
Was just settling down to a 'normalish' life after surgery late 2022 when warning signs started after Christmas and diagnosed a couple of weeks back. I'm on Trurapi (started on 4 then 6 units) & Semglee (12 , now 14 units) and now just starting to adjust dosage of Trurapi as I count carbs.
I know next to nothing about the finer points of either Trurapi or Semglee.
I must say having Libre 2 CGM and using Nutracheck app have changed everything for me. Now 98% in range with much improved diet. Very quickly worked out 1u to 6g carbs
I have to say I miss bread! I have tried a couple of times and can manage a single slice now and again but anything more and my insulin dose doesn't seem to make much difference to a large BG spike shortly after bread (even wholemeal).
So at first glance it looks as though you've totally mastered the carb counting - judging by your 98% in range. As a T3c (ie broadly as if T1) you ought to be able to find an insulin dose ratio that allows you to eat pretty well anything you want (helped by the Creon of course) including bread. Of course there is always the possibility that some breads might not work with whatever residual pancreatitis you still have, and the bathroom should give you a clue if that is the case. But I think the large spike is probably just a matter of timing: getting the carbs to digest and convert into glucose at the same time as the bolus arrives in your blood.
@Inka and
@helli have more or less already answered this aspect (I'm too slow today!). I do know that rye bread in particular has a lot of fibre content; and there is a strong suggestion that if your meal has the fibre content first, this lines your colon and slows down the digestion of carbs into glucose which in turn reduces or even prevents spikes (the prevention more so for non Ds, or T2s). I've been testing this theory for the last 3+ weeks - the jury is out on this for me so far, needs a longer trial. But certainly different sorts of bread will cause different responses in every one of us.
I dare not bake a loaf! I have enjoyed my breadmaker in the past! Maybe it's time to try some experiments with it when I'm a bit more courageous!
The bottom line suggestion from me is do experiment. Trial and learning is essential and you've got more than the minimum tools: ie bolus and basal insulin AND Libre 2. Set your low alarm at a better
Alert level of 5.6 and intercept potential hypos in a timely and comfortable manner, rather than frantically scrabbling to stay ahead of the hypo. I know my D is "brittle", changes from lowish to hypo are extremely fast, as are changes from highish to plain high. For me it's a consequence of having no panc'y and none of the hormones and enzymes that would otherwise help regulate my BG.
Couple of closing questions: have you found the thread about the limitations of CGM? Are you happy that you have a reasonable grasp on the business of Time in Range? Do keep asking questions; as you are already seeing folk here are happy to answer questions and queries.
