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T3c vs T2

J

JennyP

Well-Known Member
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I finally saw a DE after eight weeks on new double insulin. She told me I cannot be T3c until blood tests say so. Despite Pancreas atrophy on CT Scan to failure stage. I take maximum dose Creon to digest my food. The gastroenterologist showed me the CT Scan image. He laughed!

So my question is… can you have pancreas failure and not be T3c. From previous experiences I know blood tests are not 100%. And I have read that the pancreas can “ splutter” insulin as it fails …so levels can be high, low or normal. The blood tests can vary. I was given the standard T2 talk… and she is writing to my GP to order some blood tests for T1 . But overall I was very disappointed in her appt.
 
If you have a confirmed atrophied pancreas, and diabetes, I'm completely puzzled as why T3C is not the first thing to look into.
If I understand correctly, you are on the right treatment for T3C diabetes with seriously diminished insulin production, namely a basal/bolus regime plus creon?
 
Yes, the bolus insulin was added eight weeks ago. My BGL was living in the teens. And the long acting insulin was increased too. But the DE was sure it was T2 and I was just eating incorrectly. She said T3c can only be dxed with blood tests. I thought GP had done those..but not so.
But if I need max dose creon…15 a day… this shows the atrophy. Insulin if it is still being produced…would be erratic. A single blood test may or may not show accurate levels?
Only the DE can order subsidies on CGM. So it’s annoying for her to presume it’s mismanaged T2.
 
JennyP said:
But the DE was sure it was T2 and I was just eating incorrectly. She said T3c can only be dxed with blood tests. I thought GP had done those..but not so.
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My apologies, English is not my first language.
What is a DE?

JennyP said:
The last endo I saw called it Brittle Diabetes. Is this T3c?
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Brittle diabetes is not a term that is used much anymore. It just means that finding the right dosages of insulin is difficult and your insulin needs may vary. It's a term usually used for t1's.

Many diabetics who've been called 'brittle' for decades have found their various insulin to carbs ratios throughout the day with the help of CGM sensors and turned out not to be 'brittle' after all. They just had different ratios in the morning compared to the evening, and possibly depending on time of month as well.
JennyP said:
She said T3c can only be dxed with blood tests
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Blood test can show how much insulin you produce in correlation to your BG at the moment of the blood draw (a C-peptide test).
This can tell you if you produce very little insulin in relation to your bg. If so, this points to T1 or T3C. As far as I know (and I may be wrong!) there is no diagnostic test for T3C specifically, except if you've had a pancreatectomy.
So I'm not sure what blood tests she referred to.
 
DE is Diabetes Educator.
This is what puzzled me. I did not think the dx of T3c depended on the insulin number as that can vary. I have not been tested for T1 or LADA. I thought my previous GP had done that. But it’s unlikely to be those, and the pancreas failure points to T3c. I looked up the guidelines and it is a clinical dx. Takes all factors into account.
 
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