Hello
@JenniCol,
Welcome also from me to what must feel a confusing and complicated extra to your allready most difficult world.
Everything below is telling you about my experiences and does not come from any sort of medical background. It just reflects stuff I've had to learn about to make my life more sensible (I'm a big believer that "Knowledge Dispels Fear").
I personally came to the Oncology business in Nov 2019 when jaundice struck me, almost overnight, from a blocked bile duct as a tumour was trying to swallow my pancreas. [My late brother had endured cancer of the oesophagus a few yrs before and got through that; and my sister has been in almost permanent chemo treatment for 5 years from bowel cancer that was not picked up by her GP in a timely manner until she reached stage 4 - but is now fianally showing remission for over 9 months.] My Pancreatic Cancer was diagnosed (apparently it did not need a formal confirmation - it
just was PC) and surgery in Feb 20 became a total pancreatectomy which abruptly left me insulin dependent. I was discharged with a written diagnosis of Type 1 - but of course I'm actually T3c from damage to my pancreas and I don't have the autoimmune conditions of a T1 diagnosis.
After some 3 months recovering from my surgery I started Adjuvant chemo - nominal 6+ hr sessions fortnightly receiving a toxic cocktail intravenously and then on a nifty so-called pump (a plastic pressurised bottle) receiving more cocktail over the next 3 days. I did NOT cope well with this and had some pretty degrading side effects; this abruptly came to an end when I realised I was rapidly losing sensation in my feet (a legacy problem from "frost-nip" after skiing 15 yrs previously). Since then I have been closely monitored by the Oncology Department and I'm feeling truly well and scans showing all clear.
One Diabetes related issue was the steroids that I was prescribed causing 3 or 4 days with very high BG. This was tricky because at this time I had not been prescribed CGM and was finger-pricking only. Also my BG management was generally really poor and I was on what we sometimes described as "the roller coaster" from very low to very high and back again - barely touching any middle ground!
Since you are currently not on any Diabetes medication and you already have Libre 2 I can see that you are caught by getting possible excess of BG info from your sensor, yet no "tools" to help you deal with this. Without any meds your risk of going too low is very slim and more likely you will be high (above 14) far more than you feel good about and nor is it good for you!
What I couldn't glean from your postings is when you started with your oral chemo and whether there is a tentative timescale for how long that will go on. Nor did I glean when you were diagnosed as diabetic and who gave that diagnosis of T3c (but I'm guessing that was Hospital led)?
I think you now already know that T3c does not automatically mean you are or will become insulin dependent. It is quite likely - but only when your chemo has ended will any pancreatic damage be properly evident. The tests to confirm T3c are very varied, but can include ultrasound scans of your pancreas; but in the end it seems to be a judgement by Consultants from clinical symptoms that you present and no doubt supplemented from your Libre data over time.
For now you seem to be something of a spectator to your BG behaviour. I'm not sure (I just don't know) if you should try to obscure BG responses by adopting a very low carb diet and risk confusing present and future wrestling with what may well be a permanent and enduring diabetic condition. I would suggest you ask about this. It may well be more sensible to have a background (basal) insulin to help you through the chemo phase; this can be stopped if appropriate.
I'm going to pause here - you are probably already enjoying information overload. Do feel free to ask about anything that you don't understand diabetes wise. Your cancer will rightly take precedence by your health care team. I should say that even though I am now extremely well served my my Hospital based Diabetes Team my Oncologist always pleasantly tells me that they consider they still have the overall view of my collection of medical conditions!
