In your position I'd be asking for a cpeptide test (to determine how much insulin your pancreas is still producing) and a referral to an endocrinologist...I am expecting the Dr to prescribe it, and I am not sure. I also don't know if he is even going to know about pancreatitis damage and its diagnosis/management so trying to do some learning to figure out what to ask.
Thankyou. I have never met this GP before, so it is definitely going to be a lucky dip. Strongly recommended by the nurse though, so thats something.In your position I'd be asking for a cpeptide test (to determine how much insulin your pancreas is still producing) and a referral to an endocrinologist...
Good luck. My experience of GPs is that they can (sort of) cope with T2 but anything more complicated (T1 and possibly even more so T3c) they are unlikely to have much knowledge. (Having said that, you may be lucky and get a more informed GP).
Good luck.
I have no idea, though some of the T3c folk may. Just another reason why you need an endocrinologist who will be able to cope with the diabetes and the possible pancreatic disfunction.Do you know what the testing for the digestive enzymes deficiency is?
Thankyou. Another good point. I realised that I should also let my gastroenterologist know I suppose as he is the one who does my pancreas ERCP's. Brain is definitely not working at the moment.I have no idea, though some of the T3c folk may. Just another reason why you need an endocrinologist who will be able to cope with the diabetes and the possible pancreatic disfunction.
There are some conditions that can skew hba1c's.Our Hba1c's are also always wrong in that they don't align with our fasting glucose and finger prick or random glucose tests.
Hmmm.There are some conditions that can skew hba1c's.
In those situations, often a fructosamine test is used instead, not much use getting hba1c tested if it doesn't give a useful result.
In your title you say a combination of T2 and T3C (which is of course possible), but are you sure about the T2? What tests did you have to make sure you have T2 and not a different type?
Alzheimers is sometimes called T3 diabetes because it is thought by some (not proven) that it has to do with insulin production in the brain.I'm not entirely sure what you mean by T3 rather than T3c but there is also a genetic type of diabetes called MODY? (Usually gets diagnosed in slightly younger adults I believe, but my understanding is that it is caused by abnormalities in certain genes, and there are lots of different variants....)
Many people with different types of diabetes than T2 start out with gestational diabetes. It's often seen in people who develop T1 (LADA) later on as well.Thankyou @Antje77 for questioning the T2.
It's based on the advice from the endocrinologist with gestational diabetes x 2. (11 years ago) My weights back then were essentially normal, and we did not know of my pancreas issues back then.
Back then I asked about the family history aspect with my Dad and I ( back then) being normal weight, but the endocrinologist quashed it.
So you were born with a funny pancreas (unknown at the time), and you didn't have any of the usual risk factors for GD or T2.I have a history of repeated acute pancreatitis (because of a non standard pancreas shape)
Thankyou @Antje77. I agree with all your points - the science for alzheimers is not there yet on any front. Better to leave it out of the picture.Alzheimers is sometimes called T3 diabetes because it is thought by some (not proven) that it has to do with insulin production in the brain.
It has nothing to do with types of diabetes that give you high BG.
@Peanut234 , I would leave the Alzheimers out of your search, they're two completely different conditions with completely different mechanisms.
Many people with different types of diabetes than T2 start out with gestational diabetes. It's often seen in people who develop T1 (LADA) later on as well.
Makes sense to me, if something is starting to go slightly wrong with insulin production or insulin sensitivity, and you suddenly need a lot more insulin because you're pregnant, you may get GD, where in a normal, not pregnant state the body can still produce enough insulin to stay in a normal range.
It's likely more complicated than that, but if I make sense I think GD in people with a wonky pancreas wouldn't be surprising.
So you were born with a funny pancreas (unknown at the time), and you didn't have any of the usual risk factors for GD or T2.
I know who my main suspect would be.
The bigger we are, the more insulin we need, so if your pancreas was able to deal with your needs after your pregnancy, when you were thinner, it might not be able to keep it up now there's a bit more of you.
With the same BMI as I have, you'll have to be extra alert on HCP's automatically diagnosing T2, and forgetting that being fat doesn't in any way protect us from developing unrelated conditions. Being fat gives us a higher risk of misdiagnoses, or delayed diagnoses.
First step would be a C-peptide test to see how much insulin you are producing.so will be quite a tangible piece of evidence for them, which they seem to like.
I'm preparing for a potential battle. I've been told by another specialist that in my country the general practitioner/HCP? can and should do the all the testing for T3c, so i've got a list, and if they are not on board I'll see someone else.
This is very good news!I have been given an appointment for next saturday with the diabetes endocrinologist.
Good luck with talking to a GP if you have T2 diabetes. Only person I can talk to is the diabetic nurse. She even makes changes my prescription And I’m sure the GP just accepts what she decides.In your position I'd be asking for a cpeptide test (to determine how much insulin your pancreas is still producing) and a referral to an endocrinologist...
Good luck. My experience of GPs is that they can (sort of) cope with T2 but anything more complicated (T1 and possibly even more so T3c) they are unlikely to have much knowledge. (Having said that, you may be lucky and get a more informed GP).
Good luck.
Metformin usually won’t cause pancreatitis. Typically the injectables like Trulicity or tablets like Jarndice or glickazide will have an increased risk of pancreatitis. These medications will stimulate the pancrease to produce insulin where as metformin works on the liver.Hi Everyone.
A bit of an odd situation. I have a history of repeated acute pancreatitis (because of a non standard pancreas shape) and till now have been lucky with my pancreas health. However have just had a particularly bad bout or pancreatitis after some surgery and I think its been the final straw. I still have function, just not great, and am feeling rubbish.
The picture is complicated in that I had atypical gestational diabetes x2 - not overweight back then, but on insulin etc.
And also there appears to be a genetic component. My Dad has type 2, has had issues for years but kept in under control with diet, however has Alzheimers - which there is a link with type 2. ( or type 3 depending on your source) Our Hba1c's are also always wrong in that they don't align with our fasting glucose and finger prick or random glucose tests.
To complicate the situation, I am overweight, but have some essential fatty acid deficiencies which I understand can happen with pancreas insuffiency.
Anyway, the nurse did a prick test and got 18.8mol/L so am seeing the GP this week.
The nurse mentioned metformin and I read up on it, but am very concerned about the pancreatitis aspect. - I need to keep all the function I have left!
So, does anyone have any experience with metformin causing pancreatitis? or is it actually really really rare and not likely.
I am expecting the Dr to prescribe it, and I am not sure. I also don't know if he is even going to know about pancreatitis damage and its diagnosis/management so trying to do some learning to figure out what to ask.
The whole situation is a bit of a mess really. Any advice appreciated, especially about the metformin.
Hi hope you don’t mind me adding some tips for your FET-1 test for Epi you don’t need to wait to or stop creon for the test you can astray them now.Thankyou for the help everyone. I have had a rough few days with life chaos, and stress, but I did see the GP.
He does think its type3c. He was very kind, and said this is not on me, its the wonky pancreas. It was unsettling to have a doctor be that kind actually.
Anyway, Metformin for now,( he initially tried to suggest insulin and I said 'what!!!' then he double checked) though increase dose very slowly (shares the same transporter as thiamine, which I have a deficiency of, we don't even know if that transporter works for me to be honest, so that will be interesting.
Once metformin started and we know its ok, start creon.
He has ordered an elastase test, but is pretty sure I will need the creon so has prescribed that already - to start after test done.
He has also sent letter to my gastroenterologist to update him.
He actually phoned again last night. He said that my hba1c was only 51, so actually don't need metformin, but I reminded him that as we discussed, my hba1c is never correct and that my fasting is a better indicator. I shared my morning fasting numbers and he agreed that they are too high.
I felt really rude, but asked for a referral to a diabetes specialist. I expected this to take about 3 months to come through.
Its likely that this GP will move on in a few months and I would like some continuity as well as hopefully someone with a bit more 3c experience.
I'm a bit spooked as I have been given an appointment for next saturday with the diabetes endocrinologist. (she is setting up a private practice, so has gaps quite soon)
This will mean an unexpected 4 hour drive each way and possibly a stay overnight in the 'big city' but I can see family while i'm there so that is a posiitve. Thankfully insurance will cover the appointment.
I also see the GP later this week for tests to make sure my liver is happy with the metformin.
Its been a bit of a tough week, Getting to the pool was a struggle this morning, and then on top of it all I tried a modification of my physio exercises which massively annoyed my hips. Poor Kids, I'm a bit grumpy when my sugars are high, and when I'm in pain. Hopefully I can get this under control and be a better Mum.
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?