When, in all patients who have pancreatic disease, there are, the pancreas may not function quite as well as it did in health and each aspect of the function of the pancreas is an area where, which may require to be helped through improving its function by medicines. Patients who have had part of their pancreas removed, part of their body’s insulin producing cells have also been removed, and there is an increased risk or an increased incidence of diabetes following resection.

So a number of patients require to have a degree of diabetic control following a pancreatic resection. Contrary to many other diabetic patients, they also often have a requirement for a relatively high calorific intake because they’re trying to recover from an operation.

And so the advice, the standard diabetic advice regarding your diet may need to be altered by a specialist dietician to try and get a balance between your glucose control and your diabetes management.

And your nutritional recovery from your surgery.

Two things which I probably had better mention had happened to me on the way. In early December I discovered that I was diabetic. And the way I discovered that was that I developed terrific thirsts, really powerful thirst. And I began passing urine very frequently, particularly at night. And in the way that one does I looked it up on the web, and of course it, I was absolutely, it was absolutely clear that I was, I was diabetic.

So I went and presented myself, it had happened over a weekend. I went and presented myself to the GP, my GP on Monday morning, who immediately took my blood sugar level, which was dangerously high, and referred me to the hospital straightaway. Again, one of those things that I learnt was that before I went to the hospital I rang my specialist nurse, and said, I have been diagnosed as diabetic. I’m coming into A&E and would you alert the registrar and so on

So another trip to A&E?

Another trip to A&E. And it was very fortunate that I’d done that because in fact somehow the e-mail from my GP to the Diabetic team had gone astray and they were sort of denying all knowledge of me. But fortunately the oncology registrar came
down to A&E?

ame down to A&E, saw me, arranged for various blood tests to be done, confirmed the diagnosis, and gave me some, prescribed me some drugs. It was then arranged that I would go into the oncology clinic and have a discussion with the dietician about how I balanced off my diet, because at the time I was still, I was on chemotherapy which would mean that you would want a relatively high fat diet, whereas classically on diabetes you would be looking at low fat. And it in effect, the chemo won. So I was on a, on a sort of high fat diet, but low, low sugar.

And again that that worked very well because the dietician I’d already talked to about managing my diet as part of managing my chemotherapy, I already knew her; we were able to go through my diet step by step, meal by meal, about the changes that I needed to make. And the original idea was, from the oncology team, was that my diabetes would be managed by my GP, and that I didn’t need hospital treatment for that.

Do you also have to take any medicines for the diabetes? Or is it just diet?

Yes, I take a tablet morning and evening, which is not insulin, it’s a tablet, and obviously if it got worse, then there, it may be necessary for me to move onto insulin, but at the moment I’m managing fine and it’s quite interesting because I think that most people with type II diabetes, who are, have got it because of their lifestyle, they tend to be overweight, don’t take any exercise, and are notoriously non-compliant. Whereas I, you know I’m fighting for my life here, so I am doing everything that I should do, and I took in my diary for my first meeting with the diabetes consultant, and I’ve been taking my blood sugar and filling it in, and it was sort of nearly perfect. I mean it had the odd blip ah, but it was nearly perfect. And he looked at it, and he was just sort of almost astounded. And I, he said, That well he said, That’s just fantastic he said, that’s absolutely great. You’re obviously managing your diabetes perfectly. There’s nothing to worry about