Diagnosing type 3c

[RobinAnn]

Hi everyone, I'm new here and need some help.

So I've been dealing with pancreatitis for about 15 years. AIP type 2 is suspected but for now it's considered idiopathic, duct destructive chronic pancreatitis (same difference)

My GI tested fasting blood sugar and it was 108, so pre diabetes.

So now I need further testing.

After doing research, mostly I'm confused. It seems that hc1b is a diagnostic for type 2 but type 1 is diagnosed via a GTT. Is that correct?

But what about type 3c. Is the hc1b test the correct way to diagnose type 3c? Or does type 3c also require GTT?

I test my blood sugar at home off and on and it's seems to consistently show pre-diabetes. My GP did a hc1b test and it was 5.9%, which she says is normal.

How can these two tests give different results?

I understand hc1b is a 3 month average and using a meter is just a moment in time. Could it be my pre-diabetes is new enough that it doesn't show up when averaged over the hc1b 3 month range?

Would really love any input anyone has.

 

[bulkbiker]

Hi and welcome
Not a 3c expert but just for clarification are you in the US?

Your 108 mg/dl is a fairly "normal" reading of 6 mmol/l so I"m not sure how your HCP can diagnose anythign from that.

 

[RobinAnn]

Am I in US, no but close. American living in Germany.

My pre-diabetes comment was based on my lab report:
70 - 99, normal
100-125, pre-diabetes (5.6 - 6.9)

 

[bulkbiker]

In the UK HbA1c is used as a tool for diagnosis.
Yours is still just under the "pre diabetes" limit here at 5.9% or 41 mmol/mol Pre diabetes is 42 mmol/mol (6%)

 

[TigerTailz]

Hi everyone, I'm new here and need some help.

So I've been dealing with pancreatitis for about 15 years. AIP type 2 is suspected but for now it's considered idiopathic, duct destructive chronic pancreatitis (same difference)

My GI tested fasting blood sugar and it was 108, so pre diabetes.

So now I need further testing.

After doing research, mostly I'm confused. It seems that hc1b is a diagnostic for type 2 but type 1 is diagnosed via a GTT. Is that correct?

But what about type 3c. Is the hc1b test the correct way to diagnose type 3c? Or does type 3c also require GTT?

I test my blood sugar at home off and on and it's seems to consistently show pre-diabetes. My GP did a hc1b test and it was 5.9%, which she says is normal.

How can these two tests give different results?

I understand hc1b is a 3 month average and using a meter is just a moment in time. Could it be my pre-diabetes is new enough that it doesn't show up when averaged over the hc1b 3 month range?

Would really love any input anyone has.

Hi, I'm a recent 3c diabetic. This happened through Total pancreatectomy with Auto Islet Cell (Tpait) transplant surgery.
I wasn't diagnosed 3c until after having the Tpait surgery, although I had chronic pancreatitis for about 8 years prior to surgery. I also had a pancreatico-jejunostomy and gallbladder removal in 2019, but no diabetes or even pre-diabetes occurred as a result..
I only became 3c after the Tpait in April this year and didn't have to have any tests, as it is part of the surgery process. My cranky pancreas was very manky - it was full of calcifications, but was still producing insulin ok.

 

[Kinnik]

Hi RobinAnn. Sorry for the delayed response but just seen your post. In the UK HbA1c tends to be the test of choice - or at least the first test done. However for type 3c it isn’t always a good indicator as it an average, and chronic pancreatitis can initially cause dysregulation of insulin and glucagon, resulting excesses and/or deficiencies of both.

With me, for example, my HbA1c was normal. But I had a generally low sugar diet and it was only when I ate something sugary that symptoms showed up. So although I had hypos and hypers whenever I ate something my body couldn’t handle, on average it all looked fine.

Because of the HbA1c-reliance, I had to really push getting a diagnosis. Even though I knew my body was reacting differently to carbs/sugar, my GP and Gasteroenterologist both dismissed my concerns on the basis that my HbA1c looked normal. Eventually I paid for a private referral to an Endocrinologist who went beyond the HbA1c and diagnosed the issue.

Anyway…good luck and don’t rely on the HbA1c…

 

[basten60]

Hi RobinAnn. Sorry for the delayed response but just seen your post. In the UK HbA1c tends to be the test of choice - or at least the first test done. However for type 3c it isn’t always a good indicator as it an average, and chronic pancreatitis can initially cause dysregulation of insulin and glucagon, resulting excesses and/or deficiencies of both.

With me, for example, my HbA1c was normal. But I had a generally low sugar diet and it was only when I ate something sugary that symptoms showed up. So although I had hypos and hypers whenever I ate something my body couldn’t handle, on average it all looked fine.

Because of the HbA1c-reliance, I had to really push getting a diagnosis. Even though I knew my body was reacting differently to carbs/sugar, my GP and Gasteroenterologist both dismissed my concerns on the basis that my HbA1c looked normal. Eventually I paid for a private referral to an Endocrinologist who went beyond the HbA1c and diagnosed the issue.

Anyway…good luck and don’t rely on the HbA1c…

What test then did your g.i do to diagnose?

 

[Kinnik]

A glucose tolerance test. Involves fasting overnight. The fasting blood sugar level is then measured, before you then have a sugary liquid. Blood sugar levels are then tested regularly for the next few hours.

 

[Kinnik]

Also bought myself a blood glucose monitor and measured my levels regularly, then took that data to the Endocrinologist