Question about diabetes and pancreatis

[MelodyL]

This question concerns a 32 year old alcoholic who has been hospitalized MANY times with pancreatitis complications. He was diagnosed diabetic last year and given insulin and a meter but didn't use either of these things.

He has yet again been hospitalized and for whatever reason, he bounces back, (after 3 transfusions of platelets) he had been diagnosed with this long name thing but it's low platelet count.

So he was stabilized, he was sent home (after being at death's door almost) and his sugar was 350.

I was just told the following from a family member.

"He doesn't really have diabetes. He's on Levimir (the light kind) and he doesn't have to take this every day. And he can get off of this eventually. He's on Levimir to give his pancreas a rest so he can heal, and he says he'll stop drinking". What the heck is "the light kind"?

He's been drinking for 15 years and won't go to rehab so that's not happening any time soon. It's only a matter of time before he'll be hospitalized once again.

My question is as follows:

Can he be told he's a diabetic and then one year later be told "oh, you are not really a diabetic you are only on Levimr to give your pancreas a rest and once it's rested you can go off of Levimir'.

I have never heard this in all my life and I wanted to verify that this MIGHT be true.

I'm not opening my mouth, this is for my information purpose only.

Thanks much

Mel

[mrsD]

Doctors say things in general terms for patients, and often this communication is less than ideal. Sometimes the doctors themselves don't understand the process well, and sometimes the patient elaborates upon a simple comment. It can get pretty murky at times, therefore.

"light" insulin? Well there are basal insulins like Levemir and Lantus and they work all day long. Some may consider this method of action "light" since it is independent of food intake.

Then there are Bolus immediate insulins you have to inject after
every meal. Some people may refer to this as "heavy" insulin or "real" insulin. Humalog and Novolog are examples. Type I's need this all the time, because the pancreas is broken permanently.

The word used for your acquaintance is not exactly accurate.

If he damages his pancreas enough, it won't work anymore.
But it is possible he could recover. (if he is motivated to).
People with severe pancreatitis begin to spill enzymes into the abdomen outside the GI tract which is what really ends up killing them. (they digest themselves in effect).

The bleeding issue is also critical... this is how alcoholics may die. This is because the liver is too damaged to make the proper proteins for blood clotting any more. When this happens the patient bleeds out eventually and dies. One of our cousins upNorth is an ER physician and she has told us how many of these desperate patients end up. She said eventually platelets and other interventions don't work, and doctors watch these poor souls bleed to death internally mostly.

This bleeding problem, therefore is indicative of liver damage.
That may end him before the pancreas issues.

Some people though are very tough. We had a neighbor who was a huge drinker. He drank a whole fifth of vodka once at our house at a party, we hosted, in 3 hours (this was over 30 yrs ago)! He lived to his mid fifties, with a terribly red face, unable to work, and living with his mother. I can't imagine how he lasted as long as he did. So some people and last a long time, and other not. It depends on how the body reacts to the chronic poison, which is what alcohol is.

[zorro1]

A question for mrs D or anyone with knowledge about Diabetes.

I was diagnosed with alcoholic P/N about 4 years ago. The diagnoses was based on my history and normal blood sugar and otherwise a very fit 50 year old.

That was in Bangkok but recently I have received a disability pension In Australia so i decided to see my mothers neuro (she had parkinsons and F/M)

Anyway during his initial consultation he did an EMG and when it was finished he clasped his hands and with a big smile declared I have Diabetec P/N.
This is without any blood tests and with me declaring i have drunk heavily since 18years old (thought he would have jumped at the prognosis )

He prescribed a slow glucose test which i didn't have time to wait for and went back to Bangkok where i am now

today did a fasting blood sugar test , no food for 9 hours and my result came back normal, it always does.

90 < 70-110>

question, is it possible to have diabetes in this range?

I have no symptoms

Should I get the longer glucose test? dont really want to pay out of pocket for nothing.

Is my Neuro okay? A big diagnoses and he is really certain, all from an EMG

[mrsD]

Diabetes effects on nerves begin before the actual diabetes starts. And this can be many years for some people.

There is a paper on this in fact....

http://neurotalk.psychcentral.com/post810705-1.html

A long glucose tolerance test may show more for you. But you can test yourself if you have a glucometer. Do 1.5-2 hr after eating to see if you have spikes. Do testing before a meal to see if you get really low.

I just spent two days testing every 2 hours myself, because the amitriptyline was raising my sugars and right in there a tooth crown came off, due to a gum injury from the edge of the crown which had slipped to the side minutely...and I had swelling and a minor infection there. Those 2 things threw my morning fasting up 40 pts! Of course just being phobic about going to the dentist didn't help. My dentist was really nice... he fixed it all and showed me how it happened.(it is a gold crown, and metal and if they shift even a tiny bit, can cut the gum).

So if you have a highly reactive cortisol system, like I do, you can get high over various medical or emotional stressors.

This morning I am back to normal! 3 days of highs however!

Getting HbA1C done twice or 3 times a year, will show you if
you are spiking after eating. Large meals will spike a prediabetic more than smaller more conservative meals. So avoiding huge meals with long intervals, is important, to normalize the metabolsm.

Prediabetes can also be insulin resistance, and this shows up early as low or normal morning fasting for several years before the diabetes begins. Insulin resistance will show a reactive hypoglycemia on the long glucose tolerance test, and low blood sugars can impact nerves and starve them.

[mrsD]

@ Melody:

Alcoholics can be scared enough, to become motivated to
clean up their bodies. It is not very common, but does happen.

This guy you describe could have an epiphany and learn to live better. It takes help for some, because the addiction is very strong, cravings, etc. And the impulsive personality does not lend well to the rigorous life style monitoring a diabetic has to do to survive.

But we know a guy who had terrible alcohol problems, and he was arrested one night in a rural area, handcuffed and in the police cruiser on the way to jail. Just before driving off the policeman got an emergency call for a huge fatality accident, and had to turn this fellow loose so he could respond quickly to that situation. So this fellow "saw the light... narrowly missing jail and losing his license" and joined AA and is still sober today.

The epiphany is going to have to be big... losing job, freedom, family,...it will always be different for each person. I think some counseling may help too. There however, was no epiphany for our neighbor.

[MelodyL]

Mrs. D.

I hear you. The problem is the parents do not. They rescue, enable and can't see their son in any kind of pain. I have suggested Al anon and they did go to one meeting but naturally they feel "it's not for them" we are not like those people. I told them. "you ARE those people", "You all walk in each others shoes, and you all can gain strength from each other not to just jump at every crisis and let the offender deal with it himself"

Didn't make a dent in their thinking. Loving parents but much to close to the situation. We have all seen and watched countless shows called Intervention but for whatever reason, these people are determined to rescue and save their son.

I've told them. "It doesn't work that way". What amazes me is that this guy is still functioning. All these hospitalizations (and he's a very heavy smoker too).

I guess he's still being very lucky. But I am absolutely amazed that they would release a person the day after they give him a transfusion of platelets.

And he always bounces back. So many many hospitalizations. And of course they all go to the hospital.

They once asked me "What the hell are we supposed to do, not go to the hospital, not go when he calls, he needs us, etc.etc.

That's when I always say "Call up the people at Al-anon and they will walk you through this"

They did and they did NOT like what they were told to do.

So the viscious cycle of enabling begins again.

It really destroys a family, all this toxcity.

Anyway, thanks very much to all of you. Got my answers

Much appreciated.

Mel

[zorro1]

Originally Posted by mrsD

Diabetes effects on nerves begin before the actual diabetes starts. And this can be many years for some people.

There is a paper on this in fact....

http://neurotalk.psychcentral.com/post810705-1.html

A long glucose tolerance test may show more for you. But you can test yourself if you have a glucometer. Do 1.5-2 hr after eating to see if you have spikes. Do testing before a meal to see if you get really low.

I just spent two days testing every 2 hours myself, because the amitriptyline was raising my sugars and right in there a tooth crown came off, due to a gum injury from the edge of the crown which had slipped to the side minutely...and I had swelling and a minor infection there. Those 2 things threw my morning fasting up 40 pts! Of course just being phobic about going to the dentist didn't help. My dentist was really nice... he fixed it all and showed me how it happened.(it is a gold crown, and metal and if they shift even a tiny bit, can cut the gum).

So if you have a highly reactive cortisol system, like I do, you can get high over various medical or emotional stressors.

This morning I am back to normal! 3 days of highs however!

Getting HbA1C done twice or 3 times a year, will show you if
you are spiking after eating. Large meals will spike a prediabetic more than smaller more conservative meals. So avoiding huge meals with long intervals, is important, to normalize the metabolsm.

Prediabetes can also be insulin resistance, and this shows up early as low or normal morning fasting for several years before the diabetes begins. Insulin resistance will show a reactive hypoglycemia on the long glucose tolerance test, and low blood sugars can impact nerves and starve them.

"Getting HbA1C done twice or 3 times a year"

Ouch the crown coming off must have made your tooth very sensative!

Thats a coincidence , the clinic guy tried to explain HbA1c to me in broken english and asked if I wanted it done and I came to the conclusion that you had to already be a diabetic so refused it.

The blood clinic is right next door to my place and only costs $3 for single tests so I will use them now regularly. Oddly enough there is no doctor they just give you the envelope and send you away for self analysis.

Is the best time to get the HbA1 straight after a meal?

[mrsD]

HbA1C does not need fasting I believe.

It is a 4 month marker test to see how much sugar has been
incorporated into your red blood cells. It shows mostly the last 4 weeks, with the earlier times averaged in. So it is not affected by food.

This chart gives the values --the green is considered "normal".

Some doctors like mine begin diabetes diagnosis before 7.0 however. It varies depending on how they are trained.
http://www.diabeteschart.org/bloodsugarchart.html

Also the last line in green is more common in older patients.
With younger ones typically testing in the first line. Age is considered in some testing, but doesn't show on this particular chart.

And yes, my gum was really inflamed. The edge of the crown was pinching it everytime I chewed something. I think it was also infected because I had a sore throat too. But now it is all back down and like nothing happened! I have 7 crowns, and never had a problem before. I had it placed in 1993!

[MelodyL]

Originally Posted by zorrro13

"Getting HbA1C done twice or 3 times a year"

Ouch the crown coming off must have made your tooth very sensative!

Thats a coincidence , the clinic guy tried to explain HbA1c to me in broken english and asked if I wanted it done and I came to the conclusion that you had to already be a diabetic so refused it.

The blood clinic is right next door to my place and only costs $3 for single tests so I will use them now regularly. Oddly enough there is no doctor they just give you the envelope and send you away for self analysis.

Is the best time to get the HbA1 straight after a meal?

What do you mean, they give you an envelope and send you away for self analysis?? $3.00 for this. For an a1c test? Here in the states, we can go to Walgreens and buy one (actually two test in one package) for about $24.99

Good Lord $3.00. What a steal.

But the one here in the U.S. you have to do it correctly or it can be screwed up.

Take care

Melody

[mrsD]

I believe Zorrro has posted on PN that he is not in the U.S.

Things can be very different in other countries.