Bad News - Pancreas May Have Stopped Working

[Tamarante]

Last week my husband's doctor told us that his pancreas most likely stopped working some time ago. His readings are between 213 and 293 and this is before and after eating.

He was told to keep a log of his readings and to keep a food journal. He is to bring it back to her this week. She didn't have his results from that test where it tells how his readings have been for the past three months so when he goes back she'll have that.

She believes that since his readings are still high that maybe his pancreas has stopped working and he may need to be put on insulin.

Anybody experienced this or have any advice to lend me? What does this mean for him? Will he always have to take insulin from now on? Has he gone from Type II to Type I?

:confused:

[Funnygrl]

If he's not taking injected insulin and is seeing readings as low as 213, and his highest is still less than 300, I can say with certainty that his pancreas still produces insulin. A c-peptide test can be done to see how much.

I can also say with certainty that whatever insulin his pancreas is still producing isn't enough and insulin does seem like a good idea. Whether he has to take it forever or not, no one can say.

He's still a type 2. He's a type 2 with beta cell exhaustion.

[princesslinda]

When the pancreas totally stops making its own insulin, he'll have to start taking insulin, as insulin is a necessity....none of us can live without it. With the #'s he's having, I would say he still makes some insulin at this point, or it would be much higher.

If he's still making some insulin, but not enough to control his levels with diet/exercise and oral meds, he may need to start it just to get acceptable levels, then perhaps he can go off it. Bad things can happen if his blood sugars stay that high over a long period of time, so he needs to do whatever he can to get better levels.

You've mentioned before that he doesn't do a lot to help control blood sugars and doesn't eat what he should and has difficulty exercising. Perhaps insulin would help him better control things. If he's really scared of insulin, perhaps this is the wake up call he needs to get on the ball and do all he can to take care of himself.

[JediSkipdogg]

Firstly, if the pancreas totally stopped, he'd be in the ER now. Keep an eye and if you have constant results over 300 for a week then I'd get to the ER to get some insulin. You may have noticed his mood changing as it is being in those high numbers.

It could be that his pancreas was working so hard that it litterally burnt out. I generally compare this to a heart attack and old age.

It does sound like he needs insulin and the sooner the better. Once he starts on insulin, most likely it will then be for life. It will greatly help him.

He has not gone from type 2 to 1 unless he was misdiagnosed in the first place. I don't recall if you ever mentioned if he had any tests to prove if he was type 2 vs 1 or not. But your situation is quite common for type 2s as well. If his readings are steadily high (as in not fluctuating more than what you mention, then most likely he is still producing some insulin. It's just either not being used effectively or his pancreas is very weak. He could possibly get away with just one shot per day of a long acting insulin (Lantus is the most common.)

Good luck and I hope I helped some.

[Tamarante]

If he's really scared of insulin, perhaps this is the wake up call he needs to get on the ball and do all he can to take care of himself.

I hope so. I also explained to him last night that his not feeling well and this or that hurts or he's too tired is really wearing me out and it scares me. I think he's all for changing the way he eats now. I'm currently working on a list of foods that he can. I'm pregnant now so I'm on a totally different diet regiment now so what I have to eat may not work for him. I am also concerned with him being too tired to care for the baby or to play with the baby. I think that is what changed his mind about the food really.

He does agree that he needs to start exercising. Doc says that lifting weights is good since his foot is still healing and he has neuropathy. Does he need to focus on cardio more or what?

[Cyborg]

He should not do anything that would rise bg, including anaerobic exercise, until the bg is brought down.

I agree, misdiagnosis is often the case. This indeed happened to me. Ask the endocrinologist to perform a GAD Antibody and/or C-Peptide test to help confirm the type...

[Tamarante]

I hope so. I also explained to him last night that his not feeling well and this or that hurts or he's too tired is really wearing me out and it scares me. I think he's all for changing the way he eats now. I'm currently working on a list of foods that he can. I'm pregnant now so I'm on a totally different diet regiment now so what I have to eat may not work for him. I am also concerned with him being too tired to care for the baby or to play with the baby. I think that is what changed his mind about the food really.

He does agree that he needs to start exercising. Doc says that lifting weights is good since his foot is still healing and he has neuropathy. Does he need to focus on cardio more or what?

I'm glad you said this (in re: misdiagnosis) because I tend to try help doctors out or I push them to do research. Not to get off topic but it frustrates me when doctors say 'I don't know.' or try to cover up the fact that they don't know and when you start suggesting things to them they have no idea what you're talking about. LOL! Anyway, that's another issue. I feel helpless sometimes. We don't have this problem with DH's Podiatrist as he knows exactly what to do and diagnosed his Neuropathy. Which leads me to another question...I'll open a new thread for that one.

Anyhow, my husband was on Lantus after his foot surgery for about three months and they took him off. Did he feel better or have better readings...I do think so.

I didn't know there was a test that tells if a person has Type I or Type II I'll go ahead and ask his doctor about it. This is his third doctor by the way.

Diabetes has become something rather huge for us during the last year and yes, I am very ignorant when it comes to Diabetes. I'm trying to cram and understand at the same time. What other questions should I be asking his doctor?

[Funnygrl]

The problem with testing is it isn't always conclusive. For example, c-peptide may be normal for a LADA or a type 1 during the honeymoon, or low for a type 2, while it's more often high for a type 2 to normal and low for LADAs and type 1s. Antibodies are only present in 60-80% of type 1s (though if present confirm type 1 or LADA).

What really needs to be considered is the whole picture- what treatment works, age at diagnosis, risk factors, family history, etc.

[Cyborg]

The problem with testing is it isn't always conclusive.

I agree, but it sure helps to narrow it down...

Only 60% of type 1's show GAD antibodies??? :hmmmm:

[desperado]

TAM, I can only say that I hope he is doing better and if he has to go on insulin it is not as bad as it sounds. Sometimes I find my self getting mad because I have 4 shots a day and get tired of "shooting my self" I am sorry that this is so hard for you both especially with you pregnant. Good vibes sent your way:)

[LancetChick]

Whichever type he is, getting his blood sugar under control will make him feel a lot better, and much more energetic. And if he really starts paying attention to his blood sugars, and is able to achieve very tight control, he may be able to reverse his neuropathy. I'm type 1, and take oh, 5-8 injections per day (it varies), and I honestly think it's no big deal. The less educated you are about diabetes, the scarier it is. The more you know, the better able you are to manage it and realize that complications aren't inevitable. The education part costs time, but has a big payoff, so I hope your husband will get involved in that, and I wish you both good luck getting it all straightened out.

Oh, and get a referral to an endocrinologist..... PCP's know nothing about diabetes management.

[kgm0612]

With blood sugar readings of 213 to 293, his A1c is running somewhere between 8.1 and 10.4.

My question is this.........can you give us an idea of what he's eating for breakfast, lunch & dinner?

Karen

[ant hill]

With blood sugar readings of 213 to 293, his A1c is running somewhere between 8.1 and 10.4.

My question is this.........can you give us an idea of what he's eating for breakfast, lunch & dinner?

Karen

Also, what activity are you doing too. Is he kicking a ball or at the TV too much?

[Tamarante]

With blood sugar readings of 213 to 293, his A1c is running somewhere between 8.1 and 10.4.

My question is this.........can you give us an idea of what he's eating for breakfast, lunch & dinner?

Karen

Here is an example of what he could eat today:

Breakfast: Yuka w/ friend onion strips or a turkey and cheese sandwich w/ mayo on white bread (x2).

Lunch: A TV dinner or two turkey and cheese sandwiches.

Dinner: White rice, friend chicken wings and a little salad.

Snacks: Mints, fruits (peaches, grapes and bananas), muffin, sugar-free pops

Sometimes he not in the mood to eat.

[Tamarante]

Also, what activity are you doing too. Is he kicking a ball or at the TV too much?

None. Taking out the trash and walking the dog gets him beat.

[princesslinda]

Some food suggestions: Watch the bread, white rice, bananas, grapes, muffins...these are all things I have to eat only rarely. If he insists on bread, Nature's own has a double fiber bread that avgs 5 carbs/slice (after subtracting fiber). I have found I can have this on occasion. He should try and make do with only one sandwich...maybe add more meat/cheese/lettuce to make it thicker and more filling. Also, Mission Low-Carb tortillas (available at WalMart)have minimal effects on my blood sugar. Perhaps he could do a turkey/cheese/lettuce wrap on a tortilla. Or wrap it all in lettuce instead of tortilla. He definitely doesn't need to be eating white rice. Try brown rice instead, the long-cooking kind, and only ONE serving.

For snacks, make some s/f jello or jello pudding or some pork rinds or nuts.
Muffins have sugar in them and probably will make his blood sugar rise. Personally, if I eat more than 5-6 grapes, it will raise my blood sugar. I usually have 1/2 a banana when I have one (half one with him). If he really wants fruit, have him eat a small apple (with peel) or 1/2 cup strawberries or 1/4 cup blueberries with a tbsp Cool Whip topping and some pecans sprinkled on top.

S. Beach high protein cereal bars might be a good snack alternative...they are quite good.

Maybe he would be willing to try going 3 days without sugar/bread/rice/fruit and muffins just to see how his blood sugar responds.

[notme]

I think you should take some time and read up on the gylcemic index. Here are a couple of sites that may help you discover what foods your husband should be eating. It may also be helpful for him to come to this site and read.

This site explains the glycemic index. Glycemic Index and Glycemic Load (http://www.mendosa.com/gilists.htm)

This site to help discover where foods are on the index. Glycemic Index Food List from FIFTY 50 (http://www.lowglycemicdiet.com/gifoodlist.html)

[Funnygrl]

I agree, but it sure helps to narrow it down...

Only 60% of type 1's show GAD antibodies??? :hmmmm:
60-80%.

children with DIABETES - Ask the Diabetes Team (http://www.childrenwithdiabetes.com/dteam/2004-09/d_0d_ce5.htm)

"However, about 20 to 40 percent of type 1 cases will have negative antibodies, so the antibodies will only help figure out a diabetes if they are positive, not negative."

I know other people have probably read different quotes elsewhere, but that's just where I got my number from.

[kgm0612]

Your husband needs to follow a low-carb diet or read up and follow Nancy's (notme) advice regarding the glycemic index.

He also needs to get in some exercise if he's not already doing so. Walking 15 minutes (1 mile) several times a week after dinner will help keep his blood sugars down.

Karen

[Tamarante]

Some food suggestions: Watch the bread, white rice, bananas, grapes, muffins...these are all things I have to eat only rarely. If he insists on bread, Nature's own has a double fiber bread that avgs 5 carbs/slice (after subtracting fiber). I have found I can have this on occasion. He should try and make do with only one sandwich...maybe add more meat/cheese/lettuce to make it thicker and more filling. Also, Mission Low-Carb tortillas (available at WalMart)have minimal effects on my blood sugar. Perhaps he could do a turkey/cheese/lettuce wrap on a tortilla. Or wrap it all in lettuce instead of tortilla. He definitely doesn't need to be eating white rice. Try brown rice instead, the long-cooking kind, and only ONE serving.

For snacks, make some s/f jello or jello pudding or some pork rinds or nuts.
Muffins have sugar in them and probably will make his blood sugar rise. Personally, if I eat more than 5-6 grapes, it will raise my blood sugar. I usually have 1/2 a banana when I have one (half one with him). If he really wants fruit, have him eat a small apple (with peel) or 1/2 cup strawberries or 1/4 cup blueberries with a tbsp Cool Whip topping and some pecans sprinkled on top.

S. Beach high protein cereal bars might be a good snack alternative...they are quite good.

Maybe he would be willing to try going 3 days without sugar/bread/rice/fruit and muffins just to see how his blood sugar responds.

Thank you this helps. I didn't know certain fruits were bad for him. The way he was raised has a lot to do with how the way he eats now. He loves plantains, roast pork, fried pork, rice and beans, stewed cod, anything potatoes and lots of cheese. It's not easy to just turn that off since we've just started the changing process about a month ago.

[Tamarante]

I think you should take some time and read up on the gylcemic index. Here are a couple of sites that may help you discover what foods your husband should be eating. It may also be helpful for him to come to this site and read.

This site explains the glycemic index. Glycemic Index and Glycemic Load (http://www.mendosa.com/gilists.htm)

This site to help discover where foods are on the index. Glycemic Index Food List from FIFTY 50 (http://www.lowglycemicdiet.com/gifoodlist.html)

My husband is not a message board person so getting him to read and participate here. If Diabetes education was a science fiction novel he'd be here in a minute.

I will definitely use these links. Thank you! I hope I do a good job with replacing the bad foods with good foods.

[Tamarante]

Your husband needs to follow a low-carb diet or read up and follow Nancy's (notme) advice regarding the glycemic index.

He also needs to get in some exercise if he's not already doing so. Walking 15 minutes (1 mile) several times a week after dinner will help keep his blood sugars down.

Karen

He can't do any walking at the moment. He has foot pain and it looks as if he's wound is reopening again.

[Funnygrl]

He can't do any walking at the moment. He has foot pain and it looks as if he's wound is reopening again.
He really needs insulin sooner rather than later.

[ant hill]

None. Taking out the trash and walking the dog gets him beat.

Get a pedometer on him, He realy needs that exercize!!! and i think it's summertime there too so give him some water and some good music too. ;) :T

[kgm0612]

He can't do any walking at the moment. He has foot pain and it looks as if he's wound is reopening again.

He needs to see a foot doctor before he ends up with a very serious infection.

He really needs insulin sooner rather than later

I have to agree with you Funnygirl.

Karen

[volleyball]

My husband is not a message board person so getting him to read and participate here. If Diabetes education was a science fiction novel he'd be here in a minute.

I will definitely use these links. Thank you! I hope I do a good job with replacing the bad foods with good foods.

If he likes to read, get him books from the library or online that go into glycemic index and load. He is eating mostly bad foods and way to much for someone with limited mobility. Get him loads of fresh non starch veggies to eat. He'll probably resist. Since he is not moving much, you can stop enabling him. Do not bring any bad foods into the house. Limit the amount of food in the house.
Next, see if he cares enough to take care of himself. Hopefully his foot was the wake up call. You could also appeal to his pride and love for the new baby. You're going to need him healthy to take care of both of you and for the next 20 years. If that doesn't work, buy him a camcorder so that he can make video tapes for the child to be shown at special events that he won't be there for. You seem very caring of him, can you care enough to be tough, even a "b*tch?"

[Tamarante]

He needs to see a foot doctor before he ends up with a very serious infection.



I have to agree with you Funnygirl.

Karen

He already has a foot infection. It's a long story. I think I explained it in my nueropathy thread. He currently has a bone infection and his Podiatrist and Infectious Disease doctor says he could live with it but we're finding that it's opening up again, but I know he's going to say it's because of his BS not being under control. I'd like him to get his BS together and I want the bone removed and he'll just have to get used to wearing a special insert in his shooes.

So this Friday he sees his primary doctor and she is going to have his meds changed. And then he needs to see his Infectious Disease doctor again which is after the Podiatry visit in three weeks.

I'm working on it! :D

[Tamarante]

If he likes to read, get him books from the library or online that go into glycemic index and load. He is eating mostly bad foods and way to much for someone with limited mobility. Get him loads of fresh non starch veggies to eat. He'll probably resist. Since he is not moving much, you can stop enabling him. Do not bring any bad foods into the house. Limit the amount of food in the house.
Next, see if he cares enough to take care of himself. Hopefully his foot was the wake up call. You could also appeal to his pride and love for the new baby. You're going to need him healthy to take care of both of you and for the next 20 years. If that doesn't work, buy him a camcorder so that he can make video tapes for the child to be shown at special events that he won't be there for. You seem very caring of him, can you care enough to be tough, even a "b*tch?"

I've been reading the Diabetes info to him aloud and he listens. I think he's cooperating now. I got him to stop smoking three years ago so that's my biggest accomplishment with him. I've been grilling him about visiting the bodegas while I'm at work. The guys who work there says he hasn't been there in a about two week so so far so good. I don't bring junk into the house as I've suffered from HBP in the past and I don't ever want to go there again.

His problem is that he loves fried food and since I've bought one of those rotessorie (sp?) things from Ronco and we've been using that and so far so good!

He is eating a lot better than he used to. It takes time so I'm taking a little away at a time.

[volleyball]

Good for you. As far as fried foods go, you may be able to do that too. You need to get one of those high power deep fryers. The electric ones with the thermometer on it. you need this to keep the oil temp up when you put food into it. also don't fill it. The problem with fried foods is the breading. I use triscut crumbs as my breading. I don't fry very often and go through a lot of triscuts so I have a jar for all the crumbs. Anyways, you can also fry without any breading.

[Tamarante]

Update...

My husband's doctor put him on Lantus, Cymbalta and told him it was ok for him to takethe ALA. :D She's also keeping him on Avandament as well.

I'm going to keep a watch on his readings this week to see if there are any major changes.

[Worldcrzr]

Have your doctor refer you to a good diabetic nutritionist. You and your husband should do like my husband and I did and go together. I asked my doctor for a referal to go to diabetic classes and my husband went with me. When I go to see the nutritionist, he goes with me. I have his total support when it comes time to make good food choices.

If your husband eats daily what you listed or food like you listed, he will never bring his diabetes under control. He just cannot eat that many carbohydrates and fats. If he won't make the appointments, you should make them for him and make sure he goes...and you should go with him. The more you understand diabetes and what he can and cannot eat, the easier it will be for you to prepare his meals.

One warning...however...you cannot control what he eats out of your sight. He has to want to do this for himself.

[amyjo29]

I'm sorry to hear about your husband. It does sound like he is now T1. When you don't produce any insulin it's T1...he most likely will have to be on insulin from now on. Let's hope he is just doing through a ruff period and his sugars will go back down.

[LancetChick]

I'm sorry to hear about your husband. It does sound like he is now T1. When you don't produce any insulin it's T1...he most likely will have to be on insulin from now on. Let's hope he is just doing through a ruff period and his sugars will go back down.

Actually, type 1 diabetes is an autoimmune disease, completely different from type 2. A type 2 who needs to inject insulin is still type 2. I know, it's confusing.

[jerryn]

I agree with everyone here. If his pancreas shut down he'd be hitting 800 and be in the hostpital. When I was diagnosed I was at 327 in the morning. Try to get your husband an appointment with an endocrinologist.

[Funnygrl]

I'm sorry to hear about your husband. It does sound like he is now T1. When you don't produce any insulin it's T1...he most likely will have to be on insulin from now on. Let's hope he is just doing through a ruff period and his sugars will go back down.
Nuhuh. Type 1 vs. Type 2 is based on origin of disease and overall presentation. Full insulin dependence is the natural progression of type 2 and does not change what type he is.