PAI Blood Glucose Testing Guideline

[Guest guest]

,

You wrote, " Are you saying that the PAI is advising that all CP patients,

whether they are known diabetics of not, that they should self monitor? Even if

all blood glucose testing in the past has been normal? "

Yes, Following (1) research about the progression of the disease, (2)

discussing with several Pancreatologists and Diabetologists, (3) witnessing the

seriousness of undiagnosed diabetic ketoacidosis with Heidi, and (4) seeing a

couple of patients wanting the TP/ICT who thought they were not diabetic, but

when

tested, they were and they lost their second chance. So, with that said, the

only rational recommendation was to take back the responsibility for our health

and monitor ourselves at home.

I discussed it with Dr. Pete Hayden, who is doing very advanced research

about extremely early identification of islet cell damage from amyloid. There is

significant information about diagnosing patients when they are " pre-diabetic "

vs diabetic. It takes a long time for some older practitioners to change their

practice. Dr. Hayden has been a consultant for many years to the PAI when

patients have had concerns about diabetes, diagnosis, intervention, prevention,

etc. He also is very interested in pancreatitis induced diabetes, because it

mimics the amyloid induced diabetes, which is due to damage or scar tissue to

the beta cells. His research shows that large doses of folic acid in the high

risk group for diabetes, can delay the onset and degree of damage. He felt that

biweekly random glucose testing was definitely a good standard of care.

http://www.amyloiddiabetes.com/.

I also discussed this with Dr. Sutherland, who performs the Total

Pancretectomy & Auto Islet Cell Transplant. He was at the consensus that if

there was

going to be early identification of diabetes, then it would have to be the

responsibility of the patient who could do it at home on a biweekly random

basis.

Some of you may remember Dr. Yee, Neuro-Opthalmology, who spoke at the

symposium a year or so ago. He said that in the absence of a good, thorough

neuro-opthalmic exam, it would behoove the patient with pancreatitis to simply

do a biweekly random blood glucose test, so that there could be early

identification of diabetes. Waiting until you are symptomatic, polydispsia,

frequent

urination, dry skin, etc., was too late, as there would already be cellular

damage to glucose toxicity.

Some Pancreatologist say that it is years after diagnosis before there is

sufficient endocrine damage to worry about developing diabetes. The deal is that

when we are diagnosed is not necessarily the date of onset of the disease.

Therefore, we do not actually know where we stand on the scale of disease

progression.

The American Diabetes Association is also rewriting their standards of care

to emphasize the need to identify pre-diabetes vs diabetes, in patients that

are at risk. Anyone with a disease of the pancreas is at risk, without any

additional risk factors.

Karyn E. , RN

Executive Director, PAI

http://www.pancassociation.org

Pancreatitis Association International