Type 1 diabetes after pancreas removal: How to regulate?

I discovered my diabetes the same time I was diagnosed with PC 26 months ago, and have also been on insulin (fast-acting Novolog and long-acting Tresiba) since then, which included 6 months of chemo, Whipple, and 10 more months of chemo since my PC recurrence. I've got about half a pancreas left, and it's working about half capacity, so I'm also dependent on enzymes (CREON).

I'm not the most disciplined eater or insulin shooter; you should definitely seek out some professional help, but I'll share a few things I've learned.

1) Glucose highs and lows can both be dangerous. I think the lows are more dangerous (risk of coma) but you generally feel symptoms of it coming on. My monitor (Dexcom G7) emits a more obnoxious alarm that I can't disable when a low is predicted soon. Highs can induce Diabetic KetoAcidosis (DKA) which can also be life-threatening, but usually takes several hours to develop.

2) Sleep is important, but don't try to sleep through a low! For highs, I have my monitor set to alert me at night only if my glucose goes over 300 after midnight, but a lower threshold during the day. I try to avoid the fast-acting glucose within several hours of bedtime because of how often it wakes me up with an "impending low" alarm or sweats and shakes before the alarm. I've also switched to shooting my long-acting insulin in the morning instead of bedtime so it's a little less likely to wake me up with a low alarm.

3) Especially before bedtime: Avoid high-carb/sugar foods that release processed/simple sugars over the long term. I've found that rice is one of those for me. A mid-evening meal with rice can cause my glucose to continue increasing for several hours after I've gone to bed.

4) Consider exercise in place of insulin. I've found I can drop my glucose about 1 point for every minute walked at a moderate pace. As long as it doesn't get you too worked up to sleep... I do a nightly 2-mile walk (40 minutes at 3 mph) brings my glucose down about 40 points, and doesn't cause a continued risk of decrease while sleeping.

5) Beware the false high readings! I found my old G6 and new G7 would give spikes of 30-40 points while I was in the shower. Not sure if it was the moisture or the water temperature (hot), but these false spikes led me to a few bedtime insulin injections I finally figured out were not necessary.

6) Be proactive with the injections. As mentioned earlier, I'm not the most disciplined with them. I sometimes (too often) eat first and reactively inject later, and the roller coaster graphs of my glucose level clearly demonstrate I could and should be doing better.

7) Consider an insulin pump. A coworker of mine has one, and despite the need to accurately count and enter the sugar you're about to eat, he's found that to be less annoying than having to carry around the insulin pens and give himself the shots.

It takes some adjusting, but you'll get there!

Thank you for responding, I just can’t get a normal reading, but it will take time.