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Slow digestion

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That's exactly the problem, @AJLang. I bolus around 60% of the required insulin after I've eaten and then wait a couple of hours to take the remainder. There's no nausea, vomiting or bloating but there is some discomfort. I was planning to get a libre in summer but I might have to bring that forward.

I'm in regular contact with my diabetic consultant but will wait to see her to mention a pump, though that isn't for a little while. In the meantime my surgeon has prescribed erythromycin to try and push the food through instead of the gentler metaclopramide which isn't really doing much. Not looking forward to it as I've tried it before but that was soon after my op and my duodenum was twisted and friable.
 
Hi Ref that's excellent that your surgeon has prescribed erythroymycin. I have a combination of domeperidone and erythromycin four times a day. My consultant is insistent that the erythromycin is the liquid version. My GP did have a problem with this because the suspension is more expensive than the capsules but the suspension is meant to be more effective. It can be inconvenient because if the pharmacy makes it up the liquid form lasts only 14 days so we collect bottles with the granules from the chemist and make it up ourselves. Having said that it can be a right pain having the liquid whilst out and out. You may already know all of this as you've had it before. How did it affect your duodenum before?
As it is an antibiotic from time to time I give myself a break from it so that it doesn't stop being effective but the delayed digestion is obviously not good at those times. Any questions please ask.
 
Hi Andy,

Welcome to the TP club. I have been a member for almost four years. I have exactly the same problem as you, I go hypo after meals, I explained to my DSN that I am sure my insulin is taking effect before my food has turned to glucose. It happens more severely with lunchtime meals, I am on a pump but using the combo bolus where you can give a percentage of the bolus up front and drip feed the rest doesn't work for me. It's a pity there is not an option for doing it the other way round i.e. dripfeed for say half to one hour first and then the rest of the bolus. The only way I get round it is to wait until my BG has risen to about 8 mmol, this takes about an half hour or so and then I know I am fairly safe from going low. I am struggling to self-fund a CGM so that helps me gauge when to deliver my bolus. The danger of waiting like this is forgetting to do your bolus.

I have been referred to a Gastrology Dietitian and she has advised me to follow a gluten free diet for three months as well as cutting out fermentable vegetables. I have been on this diet for one month and I havent noticed much difference yet. i take 6x25000 Creon capsules with each small meal, never anything fatty, I get discomfort and my op scar starts hurting as if it is stretching if I eat too much. I had to have my my duodenum and gall bladder removed when I had the TP and this makes a big difference to digestion. I have lost 4 st in weight since my operation but I am keeping steady now.


I was on MDI for two years before I was granted a pump, its hard work but it has given me more control and the CGM is a lifesaver. If I had to choose between a pump or a CGM I would choose a CGM. A Dexcom CGM or Libre would help you a lot.

Annie
 
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It's interesting that my digestion is so different to yours @anniehi and @Ref. I wait to eat til my bg is around 5.5 to stop going hyper!

That sounds like the diet I had to follow for a while - free from practically everything! Not much fun. I'm now taking Rifaximin to deal with the bacteria partying in my gut (small intestine bacterial overgrowth) 'cos I have no stomach acid.

That's a difficult one - pump or cgm? I think if I had to choose I'd go for the cgm, but I'd hate to lose my pump. As you say the cgm is a life saver. The pump is 'just' much easier.
 
I've got it easy with my present but atrophied pancreas. 3 25000 creon with meals and 2g mesalazine for my colitis keep my digestion relatively steady
Hats off to all of you
 
Interesting stuff.

@AJLang The erythromycin is tablet form for 3 weeks. I was prescribed it previously when I was struggling to eat after my TP - my duodenum was thin, twisted and inflamed possibly due to the surgery but I think it was partly due to having a rotting pancreas next to it for 20-30 years! It was an attempt to get some nourishment into me but it just made me vomit instead.

After more testing I think I need to bolus around 1 - 1 1/2 hours after I've eaten. I'm setting reminders on my phone but I am worried I'll forget or not act upon it - could get quite tricky at work too. From what you have all said I'm going to look into a CGM or libre sooner rather than later.

@khskel - no one with an atrophied pancreas has it easy
 
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