Managing diabetes if you have pancreatic cancer – information about type 3c diabetes

• Diabetes is a condition where the amount of glucose (a type of sugar) in your blood is too high.
• Your pancreas normally makes hormones called insulin and glucagon which keep your blood glucose at the right level.
• Pancreatic cancer or surgery for the cancer can stop your pancreas making enough of these hormones. This can cause type 3c diabetes.
• Type 3c diabetes is different to type 1 and type 2 diabetes. A lot of information about type 1 and type 2 diabetes may not be right for you.
• Symptoms of type 3c diabetes can include feeling thirsty, needing to pee more often, feeling hungry, losing weight without trying to, and feeling light-headed or confused.
• There are ways to manage type 3c diabetes. Most people will need medicine to do this. This may be tablets or insulin injections.
• You may see a diabetes specialist nurse and a specialist dietitian to help you manage your diabetes.
• As well as making insulin and glucagon, your pancreas also makes enzymes which break down your food. Pancreatic cancer and surgery to remove the cancer can affect this. If you have type 3c diabetes you may have problems digesting your food. Pancreatic enzyme replacement therapy (PERT) helps with this.
• It can be confusing managing diabetes when you have pancreatic cancer. Speak to your medical team if you have any questions or worries. They will work with you to manage your diabetes.

Type 3c diabetes is different to type 1 diabetes and type 2 diabetes.

• People with type 1 diabetes can’t produce any insulin but make normal levels of glucagon. People with type 3c diabetes may produce less of all the hormones from the pancreas, including insulin and glucagon. If you have had your whole pancreas removed, you won’t produce any insulin or glucagon.
• People with type 2 diabetes make insulin but it doesn’t work properly, and they need more to do the same job. In people with type 3c diabetes the insulin works properly but they don’t make enough of it.

The different types of diabetes need to be treated differently. This means that the usual treatment for type 1 or type 2 diabetes may not be right for you if you have type 3c diabetes. If you already had type 1 or 2 diabetes before being diagnosed with pancreatic cancer, your diabetes may now need to be treated differently. Most people with type 3c diabetes will need to take medicine, which may be tablets and/or insulin injections.

You may find that type 3c diabetes isn’t as well-known as type 1 or type 2 diabetes. A lot of the information available about diabetes is for people with type 1 or 2 diabetes and may not be relevant to you. For example, there is a lot of information that encourages people with type 2 diabetes who are overweight to lose weight. This won’t be relevant to people with type 3c diabetes who have lost weight or are struggling to put weight back on.  

If you have type 3c diabetes, you are likely to also have problems digesting your food.

As well as insulin and glucagon, the pancreas also makes enzymes which break down your food. If you have pancreatic cancer, your pancreas may not make enough of these enzymes, or they may be blocked from getting to the part of your bowel where they are needed. This means that food is not properly digested.

You can take capsules to replace the enzymes that your pancreas would normally make. This is called pancreatic enzyme replacement therapy (PERT) and will help you digest your food.

If you have problems digesting your food, you won’t be fully digesting carbohydrates in your food. This means that less glucose will be absorbed into your blood. Once you start taking the pancreatic enzymes, your blood sugar level may rise because you will be digesting your food again.

This can change how your diabetes needs to be managed, and it may need to be monitored more regularly. If you notice your blood sugar levels have gone up, speak to your diabetes team as they may need to change your medicine. It’s important that blood sugar levels are treated with medicine and not by reducing how much PERT you take.