Sugars dropping - good or bad - chronic pancreatitis

deepikaneb · Jul 19, 2016

HI,
I have chronic pancreatitis, recently my sugars are constantly dropping even though i am eating food. I wanted to check if it is due to chronic pancreatits because in this disease the food is not digested properly, i am taking creon as well, so is it possible that even my sugar is not getting digested or getting used by my body efficiently, that is why my sugars are dropping inspite of eating sugary stuff? I have already reduced my insulin dose alot.
PLEASE HELP!

Thanks
Deepika

Shar67 · Jul 19, 2016

Are you going hypo, if so this is typical 3c, reduce basal insulin dose.

Milliebuglet · Aug 24, 2016

Dear Deepika,

I really do sympathise with you having had chronic pancreatitis for 4 years up until surgery in March this year.

Do you inject before or after food? Do you finish your meals or regularly leave some? I've had the same problem since surgery to remove most of my pancreas and all of my duodenum along with my gall bladder (a Whipples procedure). I now inject after the meal depending on quantity of carbs actually eaten and this reduced the daily hypo's. In addition, my nurse said that I might have been overusing my injection sites which can cause 'pooling' of the insulin which suddenly releases in one go and drops your sugars rapidly. I was experiencing 'crash hypo's' whereby my sugars could go from the 9's right down to the 2's in half an hour and without any warning or symptoms. Have a long chat with your DSN. Mine are wonderful and completely understand the difference when being a Type 'other'. Are you booked for surgery? Even a small increase in my activity has an amazing effect on my sugars so life is just one continuous testing routine. I'm hoping to persuade them to prescribe a continuous monitoring unit when I go back in November if things haven't settled.

germansheppard234 · Oct 11, 2016

Milliebuglet said:
Dear Deepika, I am in same situation it's a nightmare going from 11 down to 3 and not even left house, hosp tryed splitting insulin no luck, before then after meals no change over 12months will they ever get it right all this since I started on creon was perfect before

I really do sympathise with you having had chronic pancreatitis for 4 years up until surgery in March this year.

Do you inject before or after food? Do you finish your meals or regularly leave some? I've had the same problem since surgery to remove most of my pancreas and all of my duodenum along with my gall bladder (a Whipples procedure). I now inject after the meal depending on quantity of carbs actually eaten and this reduced the daily hypo's. In addition, my nurse said that I might have been overusing my injection sites which can cause 'pooling' of the insulin which suddenly releases in one go and drops your sugars rapidly. I was experiencing 'crash hypo's' whereby my sugars could go from the 9's right down to the 2's in half an hour and without any warning or symptoms. Have a long chat with your DSN. Mine are wonderful and completely understand the difference when being a Type 'other'. Are you booked for surgery? Even a small increase in my activity has an amazing effect on my sugars so life is just one continuous testing routine. I'm hoping to persuade them to prescribe a continuous monitoring unit when I go back in November if things haven't settled.

Refandy · Oct 12, 2016

I had a total pancreatectomy just over a year ago and have the same problem. The insulin kicks in before the food digests. If I take what insulin I need for the carbs, I hypo then without correcting I end up high. I've tested my basals endlessly and they are all good. I'm trying to resolve the problem by taking around 60% of the insulin when I eat and then the rest somewhere between 60 and 90 minutes later. Some times it works and sometimes it doesn't. It's really difficult at work as I'm having to test and inject all the time which isn't convenient or even possible. I've invested in a libre to see if that helps. It's early days but so far it has made little difference. My consultant is great and she understands the difficulties of pancreatic diabetes. I'm starting to think a pump might be the answer but even then I'm not sure if that would work as the delay in digestion seems to differ every night.
If you work out the answer then let me know.

sean1964 · Nov 6, 2016

I have same brittle problems.

My current method.
Zero Levemir. - I think if I don't appear to have a "background" insulin then why try to counteract?
I had an episode of Euglycemic diabetic ketoacidosis - this is my "evidence" to myself that I dont need levemir. I'm my own untrained Doc lol.
I eat.
When finished I inject novorapid for the full amount of carbs
I hypo. (Malabsorption)
I adjust with jelly babies.

Rubbish isnt it. But the best i've got.

Sometimes I take 0.9 or 0.8 of the full novorapid carb equivalent. But then it seems I always end up with high BS. It's an all day adjusting process with way too many variables.

Andy - Hats off to you fellow. I cant imagine how you manage to work.

One thing though. You say your consultant is great (I'm v fond of mine too).
But surely it is her job to find these answers for you?

Sean

Refandy · Nov 6, 2016

Hi Sean
I think we are all our own untrained doc.

My consultant has been a great help suggesting numerous things to try, loaned me a CGM so we could get more of a handle on what was going on and is always available by email to discuss things if I need to. That said, it is my condition, not hers, and it is in my best interests to find a way to keep my BGs stable. I've recently come to the conclusion that multiple injections is not sustainable and have asked for a pump.

I'm not sure I follow what you are saying about not needing Levemir - if I don't take my Lantus then my BGs go sky high and stay there.

Have you tried taking your Novorapid in multiple injections?

sean1964 · Nov 12, 2016

Heya Andy,

Good luck with your BG's!

Sean

(I've no idea what you mean by "multiple injections"). Oh I see you mean the way you split?
I have a needle phobia so I use as few injections as possible.

Interaud · Jan 28, 2017

deepikaneb said:
HI,
I have chronic pancreatitis, recently my sugars are constantly dropping even though i am eating food. I wanted to check if it is due to chronic pancreatits because in this disease the food is not digested properly, i am taking creon as well, so is it possible that even my sugar is not getting digested or getting used by my body efficiently, that is why my sugars are dropping inspite of eating sugary stuff? I have already reduced my insulin dose alot.
PLEASE HELP!

Thanks
Deepika

When I read this I thought I had written it without remembering! I'm in so much the same boat, but unfortunately I don't have the answer either. I tend to eat fairly high carb post-injection (although I only use the twice-daily long-lasting insulin Humulin M3) and put the rapid drop in glucose levels down to the exercise I endure doing my cleaning job between eating. How much creon do you take per meal? I currently take 4 pre-breakfast (bowl of bran flakes and x2 toast) and 4 pre-tea (baked potato, slice cold meat, veg) and only 1 per snack throughout day (all snacks are yoghurt/nuts/cheese and home-made apple/walnut scone). I really only hit the sugary stuff (i.e jelly babies) when my count hits low, but in time I'm sure you'll recognise when you're getting within that zone and can "catch" it in time. Sorry I'm useless at providing constructive advice but wish you very best in getting the answers you're looking for from the well-informed members of this great Forum.

Kirktown · Feb 28, 2017

For a while I was on the 'Jelly Baby Roundabout'. I now only inject after meals and this seems to have helped. Since being diagnosed in July last year I have put on 2.5 stone! I've started a low fat low carb diet and I am hoping this will help me reduce the amount of insulin I need to take. Nothing I can do about the raw finger tips - I need to check my BS at least 6 times a day to keep on top of everything.

deepikaneb · May 1, 2018

Shar67 said:
Are you going hypo, if so this is typical 3c, reduce basal insulin dose.

Yes few days are constantly hypo..then few days are back to normal...I think that's d pain point in type 3c..based on food absorption..your sugar fluctuates..thanks for your response

deepikaneb · May 1, 2018

Interaud said:
When I read this I thought I had written it without remembering! I'm in so much the same boat, but unfortunately I don't have the answer either. I tend to eat fairly high carb post-injection (although I only use the twice-daily long-lasting insulin Humulin M3) and put the rapid drop in glucose levels down to the exercise I endure doing my cleaning job between eating. How much creon do you take per meal? I currently take 4 pre-breakfast (bowl of bran flakes and x2 toast) and 4 pre-tea (baked potato, slice cold meat, veg) and only 1 per snack throughout day (all snacks are yoghurt/nuts/cheese and home-made apple/walnut scone). I really only hit the sugary stuff (i.e jelly babies) when my count hits low, but in time I'm sure you'll recognise when you're getting within that zone and can "catch" it in time. Sorry I'm useless at providing constructive advice but wish you very best in getting the answers you're looking for from the well-informed members of this great Forum.

I take very less Creon..only single tablet 25000 with each meal three times a day..thanks so Mich for sharing your experience..hope v all manage to survive happily

deepikaneb · May 1, 2018

Refandy said:
I had a total pancreatectomy just over a year ago and have the same problem. The insulin kicks in before the food digests. If I take what insulin I need for the carbs, I hypo then without correcting I end up high. I've tested my basals endlessly and they are all good. I'm trying to resolve the problem by taking around 60% of the insulin when I eat and then the rest somewhere between 60 and 90 minutes later. Some times it works and sometimes it doesn't. It's really difficult at work as I'm having to test and inject all the time which isn't convenient or even possible. I've invested in a libre to see if that helps. It's early days but so far it has made little difference. My consultant is great and she understands the difficulties of pancreatic diabetes. I'm starting to think a pump might be the answer but even then I'm not sure if that would work as the delay in digestion seems to differ every night.
If you work out the answer then let me know.

Life is tough isn't it..sometimes I feel if I had only diabetes..normal one..it would have been a cakewalk..but with this extra issue everything gets super complicated..digestion is beyond our control..it's really hard to adjust..I wish pancreas transplant was an option for all of us these days I can't differentiate between low symptoms n high symptoms..started using libre..I think that can at least help to some extent..you know wat ur sugar is!!

deepikaneb · May 1, 2018

Milliebuglet said:
Dear Deepika,

I really do sympathise with you having had chronic pancreatitis for 4 years up until surgery in March this year.

Do you inject before or after food? Do you finish your meals or regularly leave some? I've had the same problem since surgery to remove most of my pancreas and all of my duodenum along with my gall bladder (a Whipples procedure). I now inject after the meal depending on quantity of carbs actually eaten and this reduced the daily hypo's. In addition, my nurse said that I might have been overusing my injection sites which can cause 'pooling' of the insulin which suddenly releases in one go and drops your sugars rapidly. I was experiencing 'crash hypo's' whereby my sugars could go from the 9's right down to the 2's in half an hour and without any warning or symptoms. Have a long chat with your DSN. Mine are wonderful and completely understand the difference when being a Type 'other'. Are you booked for surgery? Even a small increase in my activity has an amazing effect on my sugars so life is just one continuous testing routine. I'm hoping to persuade them to prescribe a continuous monitoring unit when I go back in November if things haven't settled.

Thanks so much for sharing ..I inject 30mins before meal but sometimes eat early as I start feeling hypo..I am taking 15units of insulatard(long acting) and 7 units of actrapid(fast acting) in morning..and in night I take 4units of insulatard and 5units for actrapid..through pen. Can someone also tell me how to adjust insulin dose based on food intake?

deepikaneb · May 1, 2018

Milliebuglet said:
Dear Deepika,

I really do sympathise with you having had chronic pancreatitis for 4 years up until surgery in March this year.

Do you inject before or after food? Do you finish your meals or regularly leave some? I've had the same problem since surgery to remove most of my pancreas and all of my duodenum along with my gall bladder (a Whipples procedure). I now inject after the meal depending on quantity of carbs actually eaten and this reduced the daily hypo's. In addition, my nurse said that I might have been overusing my injection sites which can cause 'pooling' of the insulin which suddenly releases in one go and drops your sugars rapidly. I was experiencing 'crash hypo's' whereby my sugars could go from the 9's right down to the 2's in half an hour and without any warning or symptoms. Have a long chat with your DSN. Mine are wonderful and completely understand the difference when being a Type 'other'. Are you booked for surgery? Even a small increase in my activity has an amazing effect on my sugars so life is just one continuous testing routine. I'm hoping to persuade them to prescribe a continuous monitoring unit when I go back in November if things haven't settled.

Overusing injection sites !! Great advice!

deepikaneb · May 1, 2018

Milliebuglet said:
Dear Deepika,

I really do sympathise with you having had chronic pancreatitis for 4 years up until surgery in March this year.

Do you inject before or after food? Do you finish your meals or regularly leave some? I've had the same problem since surgery to remove most of my pancreas and all of my duodenum along with my gall bladder (a Whipples procedure). I now inject after the meal depending on quantity of carbs actually eaten and this reduced the daily hypo's. In addition, my nurse said that I might have been overusing my injection sites which can cause 'pooling' of the insulin which suddenly releases in one go and drops your sugars rapidly. I was experiencing 'crash hypo's' whereby my sugars could go from the 9's right down to the 2's in half an hour and without any warning or symptoms. Have a long chat with your DSN. Mine are wonderful and completely understand the difference when being a Type 'other'. Are you booked for surgery? Even a small increase in my activity has an amazing effect on my sugars so life is just one continuous testing routine. I'm hoping to persuade them to prescribe a continuous monitoring unit when I go back in November if things haven't settled.

Also m dealing with chronic pancreatitis since 2000 first 15 yrs wewere easy..nvr paid attention actually..only used to control sugar..but facing major challenges since two years due to exocrine insufficiency / random absorption of food

Sugars dropping - good or bad - chronic pancreatitis

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