Post Whipple procedure

[Goodwife]

Hi have been reading lots of threads an learning a lot. I am new to this forum. My husband is 8months post Whipple (due to kidney mestatstises on pancreas)and now type 1. Was type 2 before for 14 years. He is doing well taking creons for digestion but his bg are up and down now. Had odd hypo thro night. He is on humilin 1 morning and night. He never feels like eating before bed due to digestion issues but worries about going to bed on 8.9 . Wondered if anyone ele in same situation.

 

[himtoo]

Hi and welcome @Goodwife
I have moved your thread to type 1 sub forum to assist in a more focused response.

if your husband has been now diagnosed type 1 -- he should be getting an an appointment with a hospital endocrinologist
and you / he should be able to discuss concerns with the DSN at hospital too ( diabetic specialist nurse )

do keep us updated with progress

all the best !!!!

 

[catapillar]

You might want to have a look at the 3c forum - type 3c diabetes is where the pancreas isn't producing any insulin due to damage from pancreatitis and, I think, over internally caused pancreatic damage, so I think it is relevant when you have had a pancreatectomy:

http://www.diabetes.co.uk/forum/category/type-3c-pancreatic-diabetes.73/

I think 3c a bit different from type 1 in that, as well as no insulin, you are also losing all your other pancreatic functions (not sure what they are, but I'm sure it does something else, hormones etc, assuming the whippe procedure removed all or most of the pancreas, and you have to take into account the othe medications your husband might be on. But the basics on taking insulin etc are the same whatever the reason you are insulin dependent.

Is humalin 1 a mixed insulin - so he's on a fixed dose? If he hasn't got much appetite it would definitely be worth speaking to the DSN to get some advice on titrating the insulin dose down to try and avoid the night time hypos.

 

[Goodwife]

Thank you for replies. I have been reading about type 3c . This has never been mentioned to us. But am going to at next app with surgeon. Is that the same as brittle diabetes? He had a third of pancreas removed duodenum an gall bladder. Massive op. His appetite is good now but never wants to eat before bed. And on a reading of 8.9 feels low to go bed on. He is on fixed dose of 24 (increased today from 22) and 16 at tea time (reduced by 2 today). We were told by dsn at hospital that between 8 and 12 perfect. Not had appointment with endocrinologist . Am able to ring dsn anytime but not seen for proper app. Couple of nights ago he went bed on bs of 16.4 (8pm) and was 2.4 at 1.30am

 

[Goodwife]

Hi and welcome @Goodwife
I have moved your thread to type 1 sub forum to assist in a more focused response.

if your husband has been now diagnosed type 1 -- he should be getting an an appointment with a hospital endocrinologist
and you / he should be able to discuss concerns with the DSN at hospital too ( diabetic specialist nurse )

do keep us updated with progress

all the best !!!!

Thank you. Have responded but via reply button. Still navigating how to do this

 

[Goodwife]

You might want to have a look at the 3c forum - type 3c diabetes is where the pancreas isn't producing any insulin due to damage from pancreatitis and, I think, over internally caused pancreatic damage, so I think it is relevant when you have had a pancreatectomy:

http://www.diabetes.co.uk/forum/category/type-3c-pancreatic-diabetes.73/

I think 3c a bit different from type 1 in that, as well as no insulin, you are also losing all your other pancreatic functions (not sure what they are, but I'm sure it does something else, hormones etc, assuming the whippe procedure removed all or most of the pancreas, and you have to take into account the othe medications your husband might be on. But the basics on taking insulin etc are the same whatever the reason you are insulin dependent.

Is humalin 1 a mixed insulin - so he's on a fixed dose? If he hasn't got much appetite it would definitely be worth speaking to the DSN to get some advice on titrating the insulin dose down to try and avoid the night time hypos.

Thanks. Have replied on thread.

 

[catapillar]

Nope , brittle diabetes is just a name for when your insulin dependent diabetes is very difficult to control.

Type 3c is where another pancreatic disease has stopped your pancreas producing insulin (and I think it applies where you have had your pancreas, or a big chunk of it, removed).

Do tell your DSN about that big drop overnight - it sounds like doses need adjusting. The aim is to get them so you stay essentially, flat overnight without needing to eat to stay up or take insulin to stay down.

 

[Goodwife]

Nope , brittle diabetes is just a name for when your insulin dependent diabetes is very difficult to control.

Type 3c is where another pancreatic disease has stopped your pancreas producing insulin (and I think it applies where you have had your pancreas, or a big chunk of it, removed).

Do tell your DSN about that big drop overnight - it sounds like doses need adjusting. The aim is to get them so you stay essentially, flat overnight without needing to eat to stay up or take insulin to stay down.

Thanks. I am goin to ring her on Monday . We did adjust dosage today as mentioned and readings have been better thro the day. So baffling. He's just had a biscuit! An was 10.4 before retiring.

 

[himtoo]

Hi @Goodwife
after reading @catapillar 's thoughtful and knowledgeable post I am going to move your thread to the type3c sub forum where it hopefully will get some more support.

 

[Goodwife]

Hi @Goodwife
after reading @catapillar 's thoughtful and knowledgeable post I am going to move your thread to the type3c sub forum where it hopefully will get some more support.

Thanks

 

[Shar67]

Hi @Goodwife, your husband will be a 3c unfortunately lots of doctors don't know the difference.
It is sometimes very difficult to get insulin dose correct.
I found that my night time insulin was related to blood sugars in the afternoon, too much and i would be low roundabout 2pm
I also found if I reduced it I would have a night time hypo, to counter act this I would eat a biscuit before bed, if hubby cannot face food, a sweet drink would be ok
There is 2 groups that you may find helpfu
http://www.pancreatitis-forum.org.uk/(even though it has pancreatitis in name, lots of members have other panc) issues
The pancreatic tree on Facebook is the other group
Oh and in sub group.