Pancreas death

[SueJB]

How do you know that your pancreas is dying rather than becoming insulin resistant? I don't even know if it's possible for a T1D to become insulin resistant. Now remember, I'm only a young T1

 

[urbanracer]

How do you know that your pancreas is dying rather than becoming insulin resistant? I don't even know if it's possible for a T1D to become insulin resistant. Now remember, I'm only a young T1

It is possible for a T1 to become insulin resistant and the medical fraternity call this Double Diabetes.

You might need more insulin with this whereas if your pancreas was giving up the ghost then I think your glucose levels would become more stable.

What are you experiencing?

 

[SueJB]

@urbanracer Madam BG is all over the place, manic highs and then sudden low and bolus ratio needing to be increased and only having a limited effect

 

[EllieM]

How long have you been T1 and how old were you when diagnosed. I'd expect a T1 diagnosed as a child to lose insulin production quite quickly, while LADA folk seem to be able to last years in a honeymoon state....

I know that there are always exceptions, but I'd expect insulin resistance among older T1s (like me ).

Of course there are other reasons (illness, pregnancy,...) for young T1s to suddenly need much more insulin....

 

[Marie 2]

You pancreas doesn't actually die in normal Type 1's, it's just your body kills off the beta cells that make insulin. But your pancreas actually makes other hormones and enzymes for digestion.

A T1 can completely become insulin resistant and while it doesn't seem common it does happen. There is something also called brittle diabetics, and that is someone that their sugars fluctuate wildly for no apparent reason. I think, but I do not know that is more likely to happen after many years????????

Plus timing of insulin with food can be tricky with what you eat, so there is also that.

 

[Jaylee]

How do you know that your pancreas is dying rather than becoming insulin resistant? I don't even know if it's possible for a T1D to become insulin resistant. Now remember, I'm only a young T1

Hi,

A C-peptide test could be used to investigate what the pancreas is doing. Or not doing? https://www.diabetes.co.uk/c-peptide-test.html

Though, your basal insulin dosage needs may have changed, (it can happen.) which could be checked out & tweaked first prior to establishing where the bolusing could be not right.
Timing of bolus for food is also a factor. Along with the type of physical activity whilst it is onboard.

If your basal insulin dose is initially not correct? Then by "stacking" fast acting insulin to compensate can result in a "roller coaster" regarding BG levels. If on an MDI regime.

If you are having difficulty with this?
Your first port of call should be an appointment for a review with your doctor...

 

[SueJB]

How long have you been T1 and how old were you when diagnosed. I'd expect a T1 diagnosed as a child to lose insulin production quite quickly, while LADA folk seem to be able to last years in a honeymoon state....

I know that there are always exceptions, but I'd expect insulin resistance among older T1s (like me ).

Of course there are other reasons (illness, pregnancy,...) for young T1s to suddenly need much more insulin....

Thanks @Ellie-M when I say I'm a young T1, I mean I've only had it for just over 2 yrs and was a very young 64 when the beast decended.

 

[SueJB]

You pancreas doesn't actually die in normal Type 1's, it's just your body kills off the beta cells that make insulin. But your pancreas actually makes other hormones and enzymes for digestion.

A T1 can completely become insulin resistant and while it doesn't seem common it does happen. There is something also called brittle diabetics, and that is someone that their sugars fluctuate wildly for no apparent reason. I think, but I do not know that is more likely to happen after many years????????

Plus timing of insulin with food can be tricky with what you eat, so there is also that.

Thanks @Marie 2 I wondered why the pancreas wasn't whipped out if it was dead.

 

[Daibell]

Hi. If you have any excess weight that could be an indicator of some insulin resistance. It's always good when on insulin (or not) to maintain a good BMI to avoid insulin resistance and the vicious circle that can result from having too much insulin in the body. At 64 you would have been a LADA and the honeymoon period can last years. I was diagnosed at age 50 and my honeymoon lasted around 8 years. This means frequent increases in Basal shots and Bolus ratio as Beta cells die. I'm quite thin with low body fat so I don't think my changes are due to insulin resistance.

 

[EllieM]

Thanks @Ellie-M when I say I'm a young T1, I mean I've only had it for just over 2 yrs and was a very young 64 when the beast decended.

Ah, I see now why you marked my post as funny. I guess pregnancy is unlikely . But I suspect that at your age you're more likely to develop T1 slowly (aka LADA), so it's very possible that your honeymoon is coming to an end and your insulin production is finally tailing off. But don't rule out insulin reistance, particularly if you've got close family with T2.

And the pancreas is an awesome organ. It produces lots of useful hormones other than insulin. One of them is glucagon, which helps raise blood sugar if it goes too low, so is particularly helpful to T1 diabetics when they go hypo. My pancreas may be faulty, but it's still very useful. I always feel sorry for T3c diabetics, because they not only have to cope with lack of insulin but also the other pancreatic hormones.

 

[DCUKMod]

Thanks @Marie 2 I wondered why the pancreas wasn't whipped out if it was dead.

Notwithstanding the fact the pancreas does other things, as well as producing insulin, removing an organ is not without risk, and not usually done, unless there is pathology going on (like the Big C), or there are critical space issues where the ingoing organ has to go.

Lots of people have non-functioning organs inside - from kidneys to thyroids, and obviously a few more.

A friend of mine; former T1 who underwent the full shebang transplant process ended up with 3 kidneys, then when that kidney also failed, she had a further transplant making her current kidney total 4.

She had the transplant due to end stage kidney failure, then the same again. The reason she needed the second transplant was the system wrongly assessed her kidney disease to be related to her diabetes, when in fact it was a totally different thing.

She lives a good life, and is really wringing everything out of it, having faced such dark times in the past.