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Bad News - Pancreas May Have Stopped Working

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#1
Tamarante

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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:
Trying to get my Type II husband onto a healthy road. :)
Currently on: Metformin (bye bye Avandamet), Cymbalta, Lyrica, Lantus, Crestor, Naproxen, Invanz, Nexium & Ambien.
Currently working on his diet and exercise. So far, so good!!!! :proud:

#2
Funnygrl

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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.

#3
princesslinda

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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.

T2, diagnosed 8/31/06.
Meds: Metformin-ER 500 mg twice daily, HCTZ 12.5 mg every other day for BP Enalapril 20 mg 1 daily (ace-inhibitor)
Diet: I eat to my meter, generally eating 75-100 carbs/day with the occasional splurge.


#4
JediSkipdogg

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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.)

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#5
Tamarante

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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?
Trying to get my Type II husband onto a healthy road. :)
Currently on: Metformin (bye bye Avandamet), Cymbalta, Lyrica, Lantus, Crestor, Naproxen, Invanz, Nexium & Ambien.
Currently working on his diet and exercise. So far, so good!!!! :proud:

#6
Cyborg

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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...
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#7
Tamarante

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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?
Trying to get my Type II husband onto a healthy road. :)
Currently on: Metformin (bye bye Avandamet), Cymbalta, Lyrica, Lantus, Crestor, Naproxen, Invanz, Nexium & Ambien.
Currently working on his diet and exercise. So far, so good!!!! :proud:

#8
Funnygrl

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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.

#9
Cyborg

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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:
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#10
desperado

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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:)
Been out mending fences too long.......

#11
LancetChick

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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.

#12
kgm0612

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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

#13
ant hill

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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?

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#14
Tamarante

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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.
Trying to get my Type II husband onto a healthy road. :)
Currently on: Metformin (bye bye Avandamet), Cymbalta, Lyrica, Lantus, Crestor, Naproxen, Invanz, Nexium & Ambien.
Currently working on his diet and exercise. So far, so good!!!! :proud:

#15
Tamarante

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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.
Trying to get my Type II husband onto a healthy road. :)
Currently on: Metformin (bye bye Avandamet), Cymbalta, Lyrica, Lantus, Crestor, Naproxen, Invanz, Nexium & Ambien.
Currently working on his diet and exercise. So far, so good!!!! :proud:

#16
princesslinda

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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.

T2, diagnosed 8/31/06.
Meds: Metformin-ER 500 mg twice daily, HCTZ 12.5 mg every other day for BP Enalapril 20 mg 1 daily (ace-inhibitor)
Diet: I eat to my meter, generally eating 75-100 carbs/day with the occasional splurge.


#17
notme

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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

This site to help discover where foods are on the index. Glycemic Index Food List from FIFTY 50
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#18
Funnygrl

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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

"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.

#19
kgm0612

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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

#20
Tamarante

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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.
Trying to get my Type II husband onto a healthy road. :)
Currently on: Metformin (bye bye Avandamet), Cymbalta, Lyrica, Lantus, Crestor, Naproxen, Invanz, Nexium & Ambien.
Currently working on his diet and exercise. So far, so good!!!! :proud:




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