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When is action taken on Type 3c diabetes?

V

Vigman

Member
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23
Hi

I posted here quite a long time ago after I was told that due to years of chronic pancreatitis, my pancreas is calcifying and I would become type 3c.

Moving on to now, when I have fasting blood sugars of 7+ and 90 minutes after a meal of 9-10, last Hba1c was 42.

I don’t drink or smoke, don’t eat anything fried (mostly baked chicken or fish with vegetables) and can’t exercise much due to severe arthritis.
My question is, at what point do doctors start to treat type 3c? My GP seems to treat it like type 2 and has given me advice on lifestyle changes (I have a type 1 and type 2 child so am well aware of these)

At what point have type 3c patients started any treatment and what type please?

I’m already on Creon (when I can get it!)

Thanks in advance
 
Hello @Vigman,
I am a lapsed member of this forum, having decided to use the Diabetes UK forum - which is full of material from DUK itself as well as advice from the members of that forum. I am T3c after a total pancreatectomy in Feb '20.

There can be no precise answer to your question - it very much depends on what the origins of T3c were for each person and whether its progression is minimal, steady or (as in my case) immediate and abruptly fully insulin dependent. I am on MDI.

When the elevated BG leads to a diagnosis of diabetes, then only sensible detective work can lead to a T3c specific diagnosis, by recognising that there has been damage to someone's pancreas. From what I've seen and read some people can manage their BG solely by diet and general lifestyle or from oral meds only. In these circumstances it is reasonable (and in my opinion sensible) to treat someone "as if" T2. That should not make them T2, but provides a framework for their unique BG management - with the clear awareness that their relatively mild pancreatic damage could progress to them needing a different treatment plan. I am treated "as if" T1 and received the full support for T1 - but my Hospital is fully aware that I am T3c and without any pancreatic functions whatsoever, I have extra "work" to do and Think Like a Pancreas!

With an HbA1c of 42, strictly someone is NOT diabetic, but at risk of becoming diabetic; this is frequently described as pre-diabetic. Depending on how elderly that person is there could be little reason to do more than monitor. Also invariably the cause of pancreatic damage can be from some other, seemingly non diabetes related, source. Steroids (prescribed or otherwise), alcohol, accidental injury are possible causes - and the cause can need a treatment path that is contradictory, even outright unhelpful, for managing an elevated BG.

There is little commonality amongst the relatively tiny no of us diagnosed as T3c. Unlike those with T1, c. 10% of all people with D; or those with T2, roughly 90% of those with diabetes. So there isn't necessarily specific treatment paths, nor "time points" when treatment (rather than monitoring) should start. The only true commonality is that each of us have some, or lots of, damage to our pancreas. Hope this helps a little.
 
Thanks for that reply. I see that I have previously posted in another forum?
After a severe attack of acute pancreatitis about 20 years ago followed by ongoing symptoms I finally got another MRI. The consultant said that my pancreas was shrunken and calcified and I would become T3. Creon has helped me greatly but only recently has my BG become in the pre diabetic level. I’m 72.
 
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