Blood sugar level impact on chemotherapy

My blood sugars went nutso due to steroids I thought. It was awful trying and failing to control them. We seriously tried.

Lvtexas,
Thanks for sharing. We are still working on it.
Steve

Interesting article of what my nonresearcher brain could comprehend. However, when reading these scientific articles and the fact that these scenarios have to be induced into the murine or mice models and often with materials that don’t occur in the natural environment (for example the substance used to induce hyperglycemia in these mice), I’m reminded how what is done in the lab in cases like this, cannot mimic results 100% in the real world. So I would caution accepting this article and confine working with your endocrinologist regarding sugar levels that are too high or too low as either one can cause you to go into a coma. I have been on the verge of both during my post surgery pancreatic cancer journey. I do know high sugar levels can lead to organ damage so I highly recommend one works with their endocrinologist on getting sugar numbers down before on embarking on becoming hyperglycemic. I take different doses of my slow acting and fast acting insulin the week following my chemo.

Marienewland,
Thanks for the good advice. We've already started trying to get oncology/endo/primary care on the same page, but it is often a struggle.
Steve

Great Steveron that you are working with your endocrinologist! Following my distal pancrectomy, my blood sugars have gone from lows of 40 which I never knew was even possible to sustain to highs close to 500. It’s all over the place in other words. Are you wearing a glucose sensor like Freestyle Libre 3 that has an app you can use from your phone? This is critical! In my case, my oncologist and primary defer to my endocrinologist who works out how much insulin I should be getting based on my bimonthly chemo treatments. Diabetics are very sensitive to steroids and to the sugars your chemo drugs may be administered with, but you don’t want to change that. With the right endocrinologist you can find the right amounts of insulin to take during the chemotherapy treatments. I go back to my normal insulin injections less than a week following my chemo session. It’s all about the learning curve!

After 3 months of chemo and hearing weekly that we should “keep an eye on” glucise levels climbing to like 498 I finally got an endocrinologist and am trying to figure out how to use both long- and slow-acting insulin to stay below 200. It’s taking more than a couple of weeks, and boy does chemo make it harder- I did get Libre3, and it’s simply maxing out and it’s slowly dropping below 300 at midnight.

I’m afraid to take any extra insulin right before bed above what my endocrinologist encouraged.

Can we damage remaining pancreas cells with high insulin doses?

pdabrca2 I was also worried about those high insulin doses, but my endocrinologist is more concerned about high glucose lingering in the bloodstream. If you haven’t already, you can work with a dietitian to help you out together a good diet as when we are so dependent on insulin to manage the sugar and carbs in the foods we eat, diet is essential in helping to get to those lower glucose readings. I keep really low on the carbs and maybe this isn’t good advice so please consult your endocrinologist, save the work of my insulin injections for occasional sweet foods that I enjoy ( Kind bars are really good at raising your blood sugar slowly) and small amounts of frozen yogurt bars (like Yazzo). Not sure about that last one as my memory is really getting bad as of late. Immediately following chemo if blood sugar is still too high I take a “correction” dose of 2 units before I go to sleep as my endocrinologist has advised. This is what I do, but really find yourself a really Endo that will guide you along the path needed. If you lived in Orange County I could give you some good advice on drs, but I always look at where they did their medical education and frequently choose drs who attended UCLA for medical school since I know it’s very difficult to get into there based on personal experience of Friend’s son who is very bright but still wasn’t able to get in, and other children of my fiends.

Thank you.

I’m lucky enough to live near UCLA right now. I was actually looking at City of Hope, but everyone involved told me I needed to seriously consider someplace with a nearby infusion center and I can hardly complain about ending up at UCLA.

Ironically I was happy to finally be losing weight when I got an “incidental” finding of stage IV PDAC.

I’m grateful to have to worry about longer term issues like this bonus diabetes.

pdabrca2 that is so funny! I was on a diet trying to lose unwanted pounds for years when I started to lose weight very quickly due to the unknown presence of PDAC. I was happy to lose the weight too until I wasn’t. My cancer “came back” (it actually never left, was just incorrectly labeled as scar tissue around hepatic artery) after 4.5 of finishing 5FUtreatments. I’m on GAC now and the weight is coming back though my oncologist at UCLA seems pleased with it. I’m going to a work reunion very shortly so I’m trying to lose 10 pounds. So fantastic that you are at UCLA and can see your pancreatic oncologist in person!! I know you will get good care there. I just noticed your moniker says “brca2”! You have a leg up already on PDAC, my friend. I have the ATM gene mutation which doesn’t have the quite the same responsiveness (as of yet) to certain treatments as BRCA. Keep the positive attitude about attacking those blood sugar issues and you will get there.

I am a retired endocrinologist and I believe that management of diabetes is best done with an endocrinologist, the oncologists really have too much else to do and I don't think they can take on the complexity of diabetes management, doesn't need to be a center of excellence in pancreatic disease to help with the diabetes, although the oncologist might be able to recommend someone to help you. Your primary care provider might be able to advise you about an endocrinologist local to your area.