# Diabetes after pancreatitis



## Margaret Wilson (Aug 31, 2017)

Hi, Could anyone tell me if they have experienced diabetes after pancreatitis and is it inevitable that I will have to go on insulin? Thank you


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## Northerner (Aug 31, 2017)

Hi Margaret, welcome to the forum  I'm pretty sure we have had members here who haven't necessarily gone onto insulin therapy because of pancreatitis. Are you currently on any medication for diabetes?


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## Amigo (Aug 31, 2017)

Margaret Wilson said:


> Hi, Could anyone tell me if they have experienced diabetes after pancreatitis and is it inevitable that I will have to go on insulin? Thank you



Hi Margaret, I'm sure @mikeyB will be along to answer this as he's the guru in terms of pancreatitis and it's implications.
Have you been classified as Type 3c diabetes as a matter of interest? Was it a episodes of acute pancreatitis or chronic that caused your situation because everything I've read suggests much is dependent on level of pancreatic damage caused. My interest is because over 20 yrs before being dx as a type 2, I suffered a number of very severe episodes of (non alcoholic) pancreatitis so bad that they had beds in the ICU for me. I was so ill for over 4 months that they couldn't perform the gallbladder surgery I needed which was causing the issues. They'd been an expectation that I'd end up diabetic but that didn't materialise for another 20 yrs and I'm actually now diet controlled. Clearly the episodes, although of great severity, didn't cause as much damage or take out too much pancreatic function.

As northerner asks, what's your present situation regarding meds and how have they classified you? This is American based research but I found it useful. It does however relate more to chronic pancreatitis. There's probably more up to date as this is from 2015 but I found it helpful;

https://www.pancreapedia.org/reviews/pancreatogenic-type-3c-diabetes


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## Margaret Wilson (Aug 31, 2017)

Hi, Thanks for both your replies. I take metforman and forxiga. Two years ago I suffered an acute bout of pancreatitis due to gallstones. I have necrosis of the pancreas and have been left with type2 diabetes.  For the first year and a half I managed to keep my blood sugars under reasonable control but I have been told by a nurse that no matter what I do or how good I am I would need to go on insulin eventually. This has led to me going astray with my control. Has anyone got any advice? The nurse has given me another three months to try and lower my blood sugars which stand at 99


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## Amigo (Aug 31, 2017)

Margaret Wilson said:


> Hi, Thanks for both your replies. I take metforman and forxiga. Two years ago I suffered an acute bout of pancreatitis due to gallstones. I have necrosis of the pancreas and have been left with type2 diabetes.  For the first year and a half I managed to keep my blood sugars under reasonable control but I have been told by a nurse that no matter what I do or how good I am I would need to go on insulin eventually. This has led to me going astray with my control. Has anyone got any advice? The nurse has given me another three months to try and lower my blood sugars which stand at 99



I wish you luck Margaret and am really sorry to hear this has happened. If you require insulin, please don't fear it. If there is damage, clearly no amount of oral medication would make any difference. 

Good luck over the next three months with stabilising your levels. That pancreatitis is beyond painful!


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## Margaret Wilson (Aug 31, 2017)

Thank you. For taking the time to reply. I am very new to this technology, so please bear with me as I find my way around.


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## Northerner (Aug 31, 2017)

Margaret Wilson said:


> Hi, Thanks for both your replies. I take metforman and forxiga. Two years ago I suffered an acute bout of pancreatitis due to gallstones. I have necrosis of the pancreas and have been left with type2 diabetes.  For the first year and a half I managed to keep my blood sugars under reasonable control but I have been told by a nurse that no matter what I do or how good I am I would need to go on insulin eventually. This has led to me going astray with my control. Has anyone got any advice? The nurse has given me another three months to try and lower my blood sugars which stand at 99


Hi Margaret, as @Amigo says, if damage is sufficient then there may not be any choice over the use of insulin, but it isn't something you should fear of feel that it represents any sort of failure if it comes to pass - in many ways it is a much simpler and effective method of maintaining good control 

There may be adjustments you can make to your diet that could help. Many people are advied to eat a 'healthy diet', but the advice is often very vague about what this should consist of, particularly where diabetes is concerned - improved control can, in fact, be very much dependent on a person't own particular tolerances for the food they choose to eat. I'd recommend reading Maggie Davey's letter, which gives a lot of very useful - and tried and tested - information about how you can approach managing your Type 2. Very helpful in managing things and discovering your tolerances is if you can use a blood glucose meter to test your levels before and after eating, as described in Test,Review, Adjust by Alan S. If you don't have a meter then it is worth funding one for yourself in order to gather information and hopefully improve things before your next review. 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 charge up to £30 for 50 strips). Even though healthcare professionals often tell people they don't need to test unless they are on certain types of medication, like insulin) it is the best way of learning how you can tailor your diet to suit your body's tolerances whilst retaining maximum flexibility in your food choices. If you find it doesn't help and you do need the support of more medication, at least you will know you have tried!


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## Maz2 (Aug 31, 2017)

HI Margaret.  My friend has had pancreatitis a few times and she has not gone diabetic.  Her husband told me that doctors told her she would never be diabetic as she had had pancreatitis.  I think he misunderstood the doctors somewhere though because I could not see them saying that as I don't believe a doctor would tell anyone they would "never be diabetic" because I cannot see how they would know that.

I suppose it depends on the person. This is all I know about pancreatitis really so will have to leave it to those more experienced.


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## Margaret Wilson (Aug 31, 2017)

Thanks again for your comments will take all on board and make use of the forum and keep u up to date with my progress!


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## Margaret Wilson (Sep 1, 2017)

Thanks again just read Maggie Davey's letter, It was very very informative. I am seriously thinking of buying a meter and following the instructions!!!! As was said I can at least say I tried before having to take insulin. I am puzzled as to why doc.did not put me on it right away as my blood sugars are 99.????  I am told this is seriously high?  Should I be more concerned ?


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## Northerner (Sep 2, 2017)

Margaret Wilson said:


> Thanks again just read Maggie Davey's letter, It was very very informative. I am seriously thinking of buying a meter and following the instructions!!!! As was said I can at least say I tried before having to take insulin. I am puzzled as to why doc.did not put me on it right away as my blood sugars are 99.????  I am told this is seriously high?  Should I be more concerned ?


The 99 figure will be the HbA1c test result - this offers a sort of 'average' of your blood glucose levels over the 6-12 weeks prior to the test and should ideally be below 48. However, it's certainly possible to reduce the number significantly over the next few months if you are able to make the necessary adaptation to your diet and activity levels, and certainly worth a try  If you do decide to buy a meter, 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 charge as much as £30 for 50 test strips )

Do let us know if we can help in any way!


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## Margaret Wilson (Sep 2, 2017)

Thank u again for replying. I feel as though I am hearing so many conflicting stories about the food a diabetic should or as the case may be should not be eating. This is the reason I feel trying to use the machine may help.as I said I found m Davey's letter very interesting but know I could not follow her diet, but I could certainly up my exercise. In saying that I do love all the fresh veg. She talks about. Does all this make sense I feel as though I am rambling!!!!


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## Northerner (Sep 2, 2017)

Margaret Wilson said:


> Thank u again for replying. I feel as though I am hearing so many conflicting stories about the food a diabetic should or as the case may be should not be eating. This is the reason I feel trying to use the machine may help.as I said I found m Davey's letter very interesting but know I could not follow her diet, but I could certainly up my exercise. In saying that I do love all the fresh veg. She talks about. Does all this make sense I feel as though I am rambling!!!!


It makes perfect sense Margaret!  Diabetes is a very 'individual' condition, so things that work well for one person may need to be avoided by another - it's thought that each person's unique gut bacteria play an important part in determining tolerance for some food choices. As a result, it's difficult to provide 'one-size-fits-all' advice about diet. The main thing to consider is carbohydrates - things like bread, potatoes, rice, pasta, sugary foods and baked goods (pastries and pies), as these are what will raise your blood sugar levels. Some will raise the levels slowly, but others may 'spike' you and rise quickly - testing helps you determine how you react personally, and it means that you can tailor your diet more closely to your preferences and retain maximum flexibility. Why give up porridge, for example, if it is something you tolerate well?  

Exercise can really help - doesn't have to be anything requiring huge exertion, a simple half hour walk at a brisk pace twice a day will really help  This is because exercise makes your body more sensitive to the insulin your are producing, which helps to keep your levels under better control - the sensitivity lasts long after the actual exercise, and regular exercise will cause continued improvement  Do what you can, but try and make it something you enjoy and can stick with!


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## Margaret Wilson (Sep 3, 2017)

Thanks for taking the time to reply. Could u please tell me were I can buy a machine?


n boa


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## Northerner (Sep 3, 2017)

Margaret Wilson said:


> Thanks for taking the time to reply. Could u please tell me were I can buy a machine?


Yes Margaret,  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 charge up to £30 for 50 strips )


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## eggyg (Sep 6, 2017)

Hi @Margaret Wilson, sorry have just seen this thread. I had a very serious attack of pancreatitis in 2001 also caused by gallstones, unfortunately, and please don't worry it doesn't happen often, in 2007 I developed a tumour on my pancreas. I had most of my pancreas removed, along with my spleen, and luckily the tumour was benign. I didn't become diabetic until 2010 and like you was started on metformin and diet and exercise. I was always told that diabetes is a progressive disease and eventually I would have to start on insulin. Unfortunately, my "numbers" never came down no matter how hard I tried and in 2014 I was started on mixed insulin, this resulted in my BG coming right down and I felt so much better. A couple of years later they started creeping up again, I had a MRI and as was thought I have atrophy of the (little bit I have left)  pancreas. So was started on MDI (multiple daily injections) last year. Believe me when I say it was the best thing to happen to me. Your diet isn't as restricted, you can inject to cover your food. That doesn't mean you should eat cake everyday, although the odd occasion wouldn't matter! Please don't worry about going on insulin, I initially thought I was a failure not being able to control it myself but I now know differently. By the way, we are Type 3c, mind you the docs and DSNs don't refer to us as that, we are slotted into the Type 2 box as they usually don't know what to do with us! Do you take Creon as well? Please feel free to ask me any questions on here or PM me. Elaine.


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## Margaret Wilson (Sep 7, 2017)

Thanks so much for answering!! I don't know were to start,when I read your history I feel as though,in my case, I am making  things out to be more complicated than they r. You really have been through the mill. I did realise the complications  that could occur,I hsd cysts afterwords. Hope ur keeping well now!!!  I am not on Creon now.  I lost my appetite and  was able to keep my bgs quite steady but as soon as this came back that's when the trouble began. I have always had a big problem with food,being morbidly obese,since being diabetic I have lost the weight automatically now  just over 8 st. Nurse has given me 3 mths to get bgs down or its insulin. I really feel I have learned more on this site about how to control the bgs.  I better stop now or I will ramble on forever.  Once again I hope u keep well and thanks.


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## Margaret Wilson (Sep 7, 2017)

PS.would it be okay for me to ask what type of food diet do u follow and give me an example of this? Sorry if this is a silly question ,do u use a meter? I am now obsessed about what other diabetics eat!!! I am also going to let doc know about what I have learned on hear and ask for meter, probably a waste of time,they said I don't need one because I won't take hypos. Thanks again for listening. I noticed people give themselves names I should use rambler!!!!!


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## mikeyB (Sep 7, 2017)

Hi Margaret. The thing with pancreatitis is that you simply don't know how many Beta cells have been destroyed - they are the cells that produce insulin. Some people never become diabetic after pancreatitis, even those who have had partial removal of the pancreas.

But if you think about it, you taking Metformin is never going to work properly simply because you are not producing enough insulin for it work. There aren't enough beta cells left to do it.  That's obvious from your blood results. On the pancreatitis forum, _all_ of the post pancreatitis diabetics are on insulin. It's inevitable, and as eggyg says, you will feel so much better for it.

The important thing to remember is that statistically, the chances of your doctor having seen a post pancreatitis diabetic is tiny, so he/she will have zero experience of treating it. The chances of your local diabetes consultants having seen it is higher, and that's where you should be referred to at least to initiate proper treatment. You should be able to negotiate this with your doc.

I was type 1 long before I developed pancreatitis, so I'm a reverse engineered Type 3c, and I'm long used to insulin. Love it.


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## Margaret Wilson (Sep 7, 2017)

Thanks for acknowledging my ramblings. I phoned my doc today to ask for a meter(I had read m Davey's letter) I realise she has not had pancreatitis. He has decided to give me one but he also told me I will have to go on insulin!!!  The reason I want one last go before I go on it is that I felt the 99 reading was partly my fault(this may be wrong) as I was eating lots of cakes scones!sweets etc....!!!!!!!  I am lead to believe that my doc. Specialises in diabetes, but when you used the phrase "proper treatment" I was worried in case I wsd missing out on something?  I really do not feel as though my condition was properly explained other than you will have to go on insulin!! As I have said before I have  learned more about  this condition since finding the forum.  I had acute pancreatitis (necrosis) followed by cysts on the pancreas . does the above make sense to you, I will not be offended if u say NO!!!!'. All of the above has happened in the past two years, my nurse seemed to be okay with my bgs but they seemed to be going up culminating in my last 99 (as said before I felt I contributed to it).  Thanks!!!!!!


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## eggyg (Sep 8, 2017)

Hi again @Margaret Wilson. I have had a meter since my diagnosis and have no trouble at all getting as many strips as I need. I try to follow a low carb, high protein diet, no sweets, cakes, biscuits, well on occasion and that's fine. I eat Burgen soya and linseed bread, it is lower in carbs than most other bread and very tasty. I try and limit my pasta, rice and potatoes, mashed potatoes send my BGs sky high but new potatoes in their skins are fine. Sweet potatoes are fine as well as they are a slow release carb. Have a look on the food section of the forum. Also be wary of fruit as it's high in sugar, especially grapes. Soft fruits are ok in moderation, strawberries, raspberries etc. Also I don't tolerate cereal very well, I eat lots of eggs! Very versatile. As @mikeyB says we really don't know how much damage has been caused. I also suffered from pseudo cysts after my acute pancreatitis and had to have them drained, I lost 3 stones in 6 weeks and was in hospital for a month. I can truly say it was the worst time in my life, I was only 41 and had a young family, my husband thought he was going to lose me. But here I am 16 years later, fairly healthy and living each day. I don't class myself as ill or disabled, I just get on with it. I embrace my scars and still wear a bikini on the (foreign) beach, what will be will be. Please don't resist going on insulin, they will definitely give you a meter then! Our type isn't common, I like to think we are special, or as we call our selves on here, weird! And it definitely is misunderstood. Please carry on rambling! Elaine.


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## mikeyB (Sep 8, 2017)

Hi Margaret 

I'm sure would benefit from logging on to the pancreatitis forum where there are plenty of friendly folk who have trod the same pathway, so your more complex questions about the condition will get loads of answers. As I said, it's quite a rare condition. Everyone there got there in different ways, but the basic problems are the same for everyone.

https://www.pancreatitis-forum.org.uk/

I look forward to seeing you there. There are folk on this forum who do both, (including me, of course) but don't be a stranger here.


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## Margaret Wilson (Sep 11, 2017)

Still not comfortable getting round this technology BT trying mybest (will master it dome day) thank u Elaine and  mikeyb and others who have helped. To keep up to date I have now been given a meter from doc. Last chance at trying to get bgs down!!!!! I did find the pancreatic forum helpful. I do feel have been floundering with this for s while with no help but feel I am now getting help.  Elaine or anyone this might just be common sense but if u eat a meal and bgs go high is it a matter of leaving out each item to find out what is causing the highs. Thanks everyone again (getting myself  mentally ready to go on insulin) . I must say I find it very difficult!!!!


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## Margaret Wilson (Sep 11, 2017)

Rambling again how do you manage with meter, I go out quite a lot.  Do u take meter out with u!!!! I hope this does not sound too stupid!!!!


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## Ljc (Sep 12, 2017)

Hi Margaret . No question is stupid !!! 


Margaret Wilson said:


> Rambling again how do you manage with meter, I go out quite a lot.  Do u take meter out with u!!!! I hope this does not sound too stupid!!!!


When I had a meter  (I use a different system now) I took it with me and tested whenever I need to, I didn't go into loos to test.


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## trophywench (Sep 14, 2017)

Re seeing which foods to reduce the amount of, or stop having - it's only whatever has carbohydrate in it which will be the possible culprits and of course to identify them you need to know what foods are fats, what ones are proteins and which ARE the actual culprits.

Eg Roast lamb, roast and mashed spuds, cabbage, carrots and gravy.

So the spuds are the obvious thing with the most carb then root veg have it - but carrots aren't that bad though they have some (but parsnips would be bad!) and then if it's thickened gravy whatever it's thickened with (usually flour or cornflour in some form, or Bisto) all of which have carbs but not normally shedloads.  So first try cutting down on the obvious - the spud content.  Have another veg instead - like peas or runner beans or something else.  There's no carb at all in unprocessed meat and you'd have to literally eat a mountain of cabbage before you found enough carb to count - after all yes there is even carb in lettuce and cucumber but there's so much water and cellulose in them that nobody could ever possibly eat enough of it to matter in the slightest!

Although Yorkshire puds are made of flour (and eggs and milk) - there isn't a HUGE amount of carbs in one small one cos if they're made properly they should be mainly air!  However if you eat 2 or 3 or more in one go then of course it starts to mount up.


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