Glucose A1C levels after distal pancreatectomy

I had the same procedure in May 2023 for a stage 3 adenocarcinoma diagnosis. My A1c was borderline prior to surgery (5.6). I underwent 12 rounds of Fulfirinox over 6 months. During the six months of chemo my glucose and A1c levels increased slightly. By the time I completed treatment my A1c rose to 5.8. Trying to find food that was tolerable during treatment was never easy. I tended to find sweets most satisfying which probably led to the higher levels. I always found comfort eating Worthers caramels!. Since completing treatment I have tried to be more careful with my diet cutting back on sweets. My most recent A1c level was 5.5. Routine exercise is also important. I am 72 years old and my doc also indicated that the 5.8 level was not unusual for my age but I was determined to try and bring it down. More importantly, hopefully your husbands cancer is under control.

My husband has had a similar experience. He too had stage II pancreatic cancer and had a distal pancreatectomy/splenectomy in Feb 2024. Initially his glucose was fine. They did not test for a year. In Feb 2025 his A1C was 8.4. He is now on 1 g of metformin per day and doing pretty well (A1C of 7.1). they did not totally blame his diabetes on the surgery but also on the high doses on steroids (from chemo and other issues he has had), he is 68 so they said it could also be age. I don't think they can tell you for sure the reason, but I agree, it seems obvious if you are missing half your pancreas you might end up developing diabetes!!

@stevm oh I hear you with those Worthers caramels! They were a stock item in his chemo go bag! Thank you for your response. I'm happy to hear from you, we corresponded in the past regarding the surgery and you were very helpful. How are you doing? My husband's next scan is coming up in two weeks, so anxiety is high. He's feeling well and exercising daily. Like you, he's cut down on sweets and carbs and notices the difference when he tests his sugar.

@mcoplien thank you for your response. I guess we just have to go with the doctor's expertise on this and also, I guess it doesn't matter what's the cause, he's just going to continue eating healthy and exercising. How is your husband doing?

He is doing pretty well. Does not always eat right. Tries to wheel a mile a day. He is in a wheelchair so exercise is tricky. So far he is controlled with just metformin. And best of all his scans have been clear. They did a DNA blood test looking for tumor signs that was negative. His CA 19-9 keeps rising but there is no sign of cancer?

@lisn Thanks for asking. I had scans and bloodwork last week. Scans were good and CA-19-9 was 7. I'm feeling good and starting to feel cautiously optimistic as I'm now 2 1/2 years NED. It took a good year after treatment before my body recovered. I participated in the Pan Mass Challenge in August which is an annual fund raising bike ride in the Boston area in support of Dana Farber Cancer Institute. I did the one day 85 mile ride and I felt great. Although I was treated at Mass General in Boston, I have always been a supporter of DFCI. They both do extraordinary work. I know how your husband feels. The anxiety before getting scans and waiting for the results is torture. I wish him good luck. All the best to both of you.

I had a distal pancreatectomy 14 years ago. No one paid much attention to my A1C but I was fortunate to have a diabetic friend who became my diabetes mentor! For about 7 years I controlled my blood sugar with diet (I tested after meals for awhile to see what sent things soaring) and followed a fairly low carb diet. At year 7, dealing with a frozen shoulder, I had two steroid shots - well known for raising blood sugar. My pancreas never did catch up and my endocrinologist started me on a daily shot of long-acting insulin. Last year after recurrence I finally had to add insulin with meals. Poor pancreas had thrown in the towel I think.

Yes, diabetes is totally part of pancreatic cancer. It's called Type 3c. I did need to be my own advocate in finding a good endocrinologist to help keep an eye on things.

I diagnosed myself with diabetes 3C you are the first person I’ve seen who accurately identifies what type of diabetes it is. My doctor diagnosed me with type two when I corrected her she said 3C doesn’t exist. I have found a lot of other healthcare professionals. Say there’s only a type one and type two. When I explained it to him only one of them agreed with my diagnosis. I had a Whipple procedure seven years ago. Two years after the surgery, I developed diabetes because I have a smaller pancreas, which obviously produces a smaller amount of insulin. My A1c went up and I’ve controlled it with diet and.Jardiance. God bless you. 🙏🏼💜🌈