# Post transplant onset Diabetes.



## Multicat (Nov 14, 2011)

Hi there, I had a Renal transplant 13 years ago when I was 46, I was born with kidney reflux.
After my transplant I developed Diabetes (on Tacrolimus) and have been on insulin ever since.
I have tried asking this question in several forums & have never received a reply, as this is a very active forum I thought I would ask here.

Where do I put myself when looking for information, which always seems to be split into type 2 & type 1.
I am going to ask when I see the nurse next time, but as my memory is very dodgy from renal failure I can't guarantee I will.


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## am64 (Nov 14, 2011)

hi and welcome , i cant help you personally but just wanted to say hello and am sure someone will be on to help you soon ..in the meantime have a good look around and remember no questions are regarded silly here x


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## Multicat (Nov 14, 2011)

*Thanks*

That is so kind thank you. I registered in May but haven't posted till now, as I don't feel as if I fit in a niche.


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## Northerner (Nov 14, 2011)

Hi Multicat, welcome to the forum  We do have a wide range of reasons that members have developed diabetes and some have been diagnosed after using steroids or immuno-suppressants. Could you give us some idea of the type of information you are looking for? What insulin regime are you on, and what difficulties have you encountered in managing your diabetes? How is your control generally and do you see a consultant or just your nurse.GP?

Sorry for firing lots of questions back at you! I hope that our members are able to help you find the answers you are looking for, so please ask away  We don't separate the forum into different types, because many of the problems encountered are similar, whatever the origins of the diabetes


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## Multicat (Nov 14, 2011)

Hi Northerner, Thank for your reply.
I want better control, I used to go to the hospital in Cardiff, but then I was sick  I had Multiple Pulmonary Emboli hollowed by PTSD so I was seeing my GP.
Now I have moved & haven't seen anyone yet, I'll see a diabetic nurse at my GP surgery, I am on Lantus & Novarapid, my control is variable & I struggle with my weight partially due to so much medication for my kidney, heart, breast cancer etc. I have recently been diagnosed with Osteoporosis too. 
Now my control seems to me that it is hardly ever where it should be 5-6, I either am either 8-9 or hypoing at 3-4. 
I am pleased you don't divide the forum into 1 or 2, I did join a group once, but everyone was type 2 & not on insulin, I felt a bit out of things.
I think I have covered most things, but fire away if there is anything else.


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## am64 (Nov 14, 2011)

Multicat said:


> That is so kind thank you. I registered in May but haven't posted till now, as I don't feel as if I fit in a niche.



dont worry about that here we don't segregate the forum into different types ...we are a support forum and welcome all connected with the ole D x


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## Multicat (Nov 14, 2011)

Thank You perhaps I have found where I fit.


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## Mark T (Nov 14, 2011)

Welcome to the forums Multicat


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## slipper (Nov 14, 2011)

Hi Multicat, welcome to the forum


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## Northerner (Nov 14, 2011)

Multicat said:


> Hi Northerner, Thank for your reply.
> I want better control, I used to go to the hospital in Cardiff, but then I was sick  I had Multiple Pulmonary Emboli hollowed by PTSD so I was seeing my GP.
> Now I have moved & haven't seen anyone yet, I'll see a diabetic nurse at my GP surgery, I am on Lantus & Novarapid, my control is variable & I struggle with my weight partially due to so much medication for my kidney, heart, breast cancer etc. I have recently been diagnosed with Osteoporosis too.
> Now my control seems to me that it is hardly ever where it should be 5-6, I either am either 8-9 or hypoing at 3-4.
> ...



Have you been taught how to carb count i.e. adjust your insulin doses according to the amount of carbs in your meals (plus various other variables to take account of!) If not, then it would be worth asking what education courses are available to you. It's not surprising that you struggle with your weight with the things you have to deal with, so try not to be too hard on yourself. We have a very supportive Weight Loss section here if you need advice and encouragement - everyone will do what they can to help you 

Your control is not too bad, it just sounds as though you need a bit of fine-tuning - what have your HbA1c tests been like? I would consider asking to be referred to a diabetes consultant/endocrinologist if you find your GP or practice nurse lack the necessary knowledge to help you, as you clearly not a run-of-the-mill patient and may need more specialised help than they can provide.


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## teapot8910 (Nov 14, 2011)

Multicat said:


> Thank You perhaps I have found where I fit.



You have indeed  Welcome to the forum!


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## Multicat (Nov 14, 2011)

Thank you teapot, I cannot believe how caring you all are.

Northerner- I haven't had any sort of carb counting training I will ask about that. Also because of my transplant I was told my blood at 5-6 to protect the kidney, which is not as good as it was, but still functioning. Hurray!
My HbA1c is usually around 8 although I do get the occasional 5 or 10, I particularly have a problem with my morning levels though, often get a 9-10, but I was reading on here that is may be going too low in the night then rebounding to high. Not heard of this before.


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## Northerner (Nov 14, 2011)

Multicat said:


> Thank you teapot, I cannot believe how caring you all are.
> 
> Northerner- I haven't had any sort of carb counting training I will ask about that. Also because of my transplant I was told my blood at 5-6 to protect the kidney, which is not as good as it was, but still functioning. Hurray!
> My HbA1c is usually around 8 although I do get the occasional 5 or 10, I particularly have a problem with my morning levels though, often get a 9-10, but I was reading on here that is may be going too low in the night then rebounding to high. Not heard of this before.



The morning higher levels may also be due to 'dawn phenomenon' - this is when your liver is stimulated by raised levels of cortisol in the morning to release extra glucose into your blood, to give you a boost to get you going in the morning. Unfortunately, as people with diabetes, we'd rather not have that boost because our bodies don't deal with it very well! I get this to some extent and find that injecting shortly after rising and having some breakfast helps to stop the rise.

You can check to see if you are getting rebound highs by testing at 3 am when levels are normally at their lowest. If your levels are reasonable at this time then it's less likely that you are getting rebound highs.


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## Robster65 (Nov 14, 2011)

Hi Multicat. Welcome. 

Pleased you're feeling at home. We like to help, rather than categorise 

I would imagine your mix of meds makes it very difficult to balance BGs, so you're doing well considering.

Rob


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## Copepod (Nov 15, 2011)

Welcome Multicat - glad you like not being categorised into forum sections. 

Some people choose to put their medication regime in their signature, plus details such as age of diagnosis and how they came to have diabetes. You're welcome to do so, although people can always check back to this introduction thread. 

In some way, categories are important eg which course you can attend - DAFNE or BERTIE for type 1, DESMOND for type 2 - but people who don't neatly fit eg LADA or MODY (generally slower onset, in adulthood, leading to needing insulin) have problems getting on course. 

Anyway, we'll try to help in any ways possible - there's masses of advice about diabetes and lots of other topics. I particularly appreciate receiving advice about keeping ducks and promoting orienteering, adventure racing, geocaching etc


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## samade10 (Nov 15, 2011)

Northerner said:


> The morning higher levels may also be due to 'dawn phenomenon' - this is when your liver is stimulated by raised levels of cortisol in the morning to release extra glucose into your blood, to give you a boost to get you going in the morning. Unfortunately, as people with diabetes, we'd rather not have that boost because our bodies don't deal with it very well! I get this to some extent and find that injecting shortly after rising and having some breakfast helps to stop the rise.
> 
> You can check to see if you are getting rebound highs by testing at 3 am when levels are normally at their lowest. If your levels are reasonable at this time then it's less likely that you are getting rebound highs.



Hi funny enough i was at hospital yesterday talking about spikey blood sugars over night. Northerner is spot on with the kidneys releaseing glucose to get you going. Having your novorapid then breakfast should help.

Im having hypos 1st thing in the morning and couldnt understand why my bs was sky high a few hours later, apparently again your kidneys release glucose to deal with the hypo and cause this.

Ive had diabetes for 28 years and im still learning.

Samantha x


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## AlisonM (Nov 15, 2011)

Hi Multicat and welcome in. We have all sorts and I must say I really like that fact that it makes no difference what 'Type' you are to anyone here. We have every flavour imaginable, but that doesn't help me guess which one you would be.


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## Jennywren (Nov 15, 2011)

Multicat said:


> Thank You perhaps I have found where I fit.


 Course you do  One big happy family here , welcoe to the forum Multicat


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## Multicat (Nov 15, 2011)

Thanks again folks I expect I run into you all on the forum. I have had a go at putting some details in my signature as suggested, now spending time going through reading question other people have asked, I am learning fast!! I have even chimed in one or twice, now don't feel so isolated.


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## Northerner (Nov 15, 2011)

Multicat said:


> Thanks again folks I expect I run into you all on the forum. I have had a go at putting some details in my signature as suggested, now spending time going through reading question other people have asked, I am learning fast!! I have even chimed in one or twice, now don't feel so isolated.



If there is ever anything you are having difficulty with, you can contact me through the 'Contact' link at the top of the screen and I'll try my best to help!


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## trophywench (Nov 16, 2011)

Hiya!

If I had to categorise you, I'd say Type 1 off the top of my head, TBH.  But who cares?

Well I care - I care what treatment you get, and you really DO need to ask for a referral to the hospital to see someone who understands in detail exactly what has happened to you and how to deal with it now.  And that person(s) do not work in a GP's surgery anywhere in the UK.  

IMHO, LOL

As others have said, your 'Categorisation' on medical records is important as far as getting on useful/relevant courses is concerned, and also to some extent treatment - because - just for instance - as things stand at the moment anyway - if they labelled you T2, you just wouldn't qualify for an insulin pump.  You may not want one at the moment anyway, but that's not the point really, is it!

Or your PCT may decide to limit blood test strips for T2's or something, and OK I know T2's on insulin are sposed to be able to get them anyway but some surgeries just make stuff awkward quite unnecessarily and we have enough to battle with without having a Mexican stand-off with the GP.


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## Multicat (Nov 16, 2011)

Well now that's another thing I must see what the pump is all about, more reading to do.
Also I did at one time have my prescription for test strips returned as someone had decided I was having to many, the only was I could get more was to see my GP. He went potty shot out of his surgery, came back plonked down & said you won't have any trouble anymore. Followed by a muttered comment that I didn't quite catch. Me? I just said thank you took the prescription and laughed my head off outside, I had never seen him like that before usually very gentlemanly & calm.


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## grahams mum (Nov 16, 2011)

Multicat said:


> Hi there, I had a Renal transplant 13 years ago when I was 46, I was born with kidney reflux.
> After my transplant I developed Diabetes (on Tacrolimus) and have been on insulin ever since.
> I have tried asking this question in several forums & have never received a reply, as this is a very active forum I thought I would ask here.
> 
> ...



hi and welcome yes we are the BEST FORUM and very active !!!


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## Bluebaldybob (Nov 17, 2011)

Hi Multicat, and welcome. You won't find a better bunch of people anywhere than on this forum.
I've been on here every day since September this year when my daughter was dx type 1. The amount of support and advice is fantastic. I'm sure you will enjoy your time here


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## Lady Willpower (Nov 20, 2011)

Hey Multicat, welcome. I know what you mean about not fitting in. I was born diabetic when I met others while I was growing up none of them were my age and when I finally met kids my age they all seemed to eat properly and never have hypos or highs or hate being diabetic like I did. I felt that I never fit in anywhere but I do here and it has taken me over 40 years so I am really glad that you are here, everyone fits in here and they are all so lovely and extremely truthful. If I were you I would be bashing my doctors door down and telling him how you feel and ask him to put you in touch with your hospital immediately and get some support from people that know about your conditions. I am sorry to hear about all your health problems but now you are here your diabetes won't be a problem


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## Multicat (Nov 21, 2011)

Bashing door arm at the ready Lady Willpower, I have an appointment at my GPs surgery in December to see the nurse, so I will start then. 

I am feeling much happier since I joined the forum, I don't know why, but I really resent the Diabetes, but seem to cope with my other problems. I think its because I felt so alone, not now, all your supportive comments have buoyed me up no end.
Thank you, thank you, thank you.


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