Chemotherapy and type 1

I am due to start chemo and radio therapy for breast cancer next week and I have been given Capecitabine tablets. Has anyone out there had experience of chemo and type 1 and how did it affect your glucose control?

jackie_b said:

I'm type 2, but finished chemo and had my first RT today, hang in there x


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Thank you Jackie. How did it affect your glucose control? Did you get highs or lows? I use a pump so can adjust, but not sure what to expect.

Hydie said:

Hi Jane

I am afraid I also cannot answer your question but I am on a similar journey to you, just a few months behind. I start chemo on Wednesday. My diabetes team have been zero help, "good luck with your treatment" was all I got and the oncologist just shrugged about diabetes too. I have not been put on any tablets, nor am I having radiotherapy, but I did have a bilateral mastectomy and my insulin requirements went through the roof.
On Friday I had a PICC line put in to avoid cannulas during chemo (they made a bit of a mess of the veins in my hands in the 3 surgeries I had in March) and my glucose is all over the shop with no symptoms... I was 23 after breakfast yet I felt fine! I am really worried that I am not going to manage my diabetes at all well and that this might affect the chemo (in its effectiveness as well as side effects) and or that I will cause some long term damage.
Until now I have really had it easy with diabetes, only had it 8 years and it's been largely stable and totally manageable and predictable. Now I don't know where I am and am really worried

Any advice from your journey so far would be greatly appreciated

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Are you type1 or 2? If you are 1 I would ask for a pump as a matter of urgency. It does make life a lot easier as you can adjust the dosage tom suit lows and highs. If type 2 you may have to use insulin, but your Consultant should be able to advise you on that.

Hydie said:

Thanks for your response Jane, I am Type 1, when I asked about a pump they advised against it saying that it would take me a while to get used to using it, but quite frankly I am at a loss on my current regime... Are you on a pump and how quickly did you get used to controlling with it? Are you finding chemo (or related steroids, sickness etc) affects your normal insulin requirements? I am wondering if (hoping!) my sugars will calm down once my body realises the PICC is here to stay.

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I had a short course on carb. counting as you need that to operate the pump, but once I had had that I found using the pump much better than injections and my glucose levels were more stable. I am having to have about 40% more basal insulin, but the bolus for when I eat is about the same. With the pump you only have fast acting insulin and it runs 24 hours a day. You have to use a bolus when you eat carbs and the team should be able to advise what ratio of bolus you need. I also have Addisons Disease so have to have steroids daily too and that causes higher glucose levels, so I have a bolus of twice the normal level anyway, as the steroids affect the way insulin works in the body. Chemo will almost certainly mean higher insulin doses, but my advice is keep checking your blood, say, every 4 hours or so and keep a record. That way the Diabetes team can probably advise you further. I would say the pump is the best thing since sliced bread!! I got used to it very quickly and my team were on call every weekday so I could get advice quickly. They were, however, like your team, not very helpful when I started chemo, probably because they had never come across it before?? Fortunately the chemo tablets do not make me sick, although I was sick at first and they halved the dose. I am now not sick and do not lose my hair. My cancer was breast cancer and I had a mastectomy 4 years ago. Unfortunately, although I was on Letrozole, Aromasin and Tamoxifen, one after the other, the cancer recurred in my lymph glands under my arm and I had to have them removed a week before Christmas. Another bit of advice - I don't drink alcohol, tea, cola or coffee and that certainly helps as I am not taking stimulants into my body. If you want to email me directly (janetmatthams@hotmail.co.uk) I can give you my phone number so we can talk.
Janet