Happy Saturday!! Hope you are enjoying your weekend!!
At a recent endo apt, I learned an interesting fact about glucagon production in T1D versus surgical T1D. Again, although I’m an RN, for the purpose of this blog I am not a diabetes professional and you should ask your T1D team for further info and confirmation of what is offered here. Now, with that out of the way, let me tell you what I learned…
I asked my doc about glucagon in the diabetes population. I had heard conflicting information regarding the different types of diabetes and the PWD’s ability to produce glucagon. In T2D, the person’s alpha cells that produce glucagon work ok in the beginning of the disease process. But as the disease progresses, her/his ability to produce glucagon is diminished.
In the straight up, immunodeficient T1D, again the alpha cells are able to produce glucagon, but when the beta cells which produce insulin are unable to do so, the alpha cells get confused. Medical science has not come up with the reasoning behind this yet, but we’re hoping they are able to do so at some point in the future! These confused alpha cells, produce some glucagon but are not able to get it where it needs to go in the event of a low.
In surgical T1D, there is no production of glucagon because the alpha cells have been removed along with the beta cells and the rest of the pancreas. I’m hoping to have a discussion with my transplant surgeon soon, so I can ask him if alpha cells are transplanted along with the beta cells during the auto (meaning your own cells so no immunosuppressant drugs are necessary) islet cell transplant that occurs in the type of surgery I had for chronic pancreatitis. I’m not sure if the purification process that currently is available can separate the alpha from the beta or if they just get transplanted together and we all hope for the best. Plus, I’d like to know if the alpha cells are as sturdy as the beta cells and do they survive the purification and transplanting process. I’ll get back to you when I know more on this point.
It’s important, if you are on insulin therapy to ask your doctor for a glucagon prescription and carry it with you at all times. It’s better to have it and not need it, than to need it and to be without. My endo didn’t offer it to me but after reading many articles on the DOC (Diabetes Online Community), I learned that I needed a script. My doc didn’t hesitate to give me one but it confuses me that we have to ask for it when, I believe, it should be offered to anyone on insulin therapy. That’s because, it is more likely to experience a low with insulin than other forms of treatment, so we should be prepared just in case.
There are instructions in the glucagon case on how to use it and there are many youtube.com videos detailing how to use it. as well as, an iPhone free glucagon app that is an excellent resource for friends with an iPhone. I have had glucagon get-togethers with friends and family with the purpose of explaining lows to those who love me and also, explain the glucagon and how it is used. I take expired glucagon kits and let friends and family practice with them. This goes a long way when and if there is ever a low that I can’t reverse by myself. Hopefully soon, as a result of all the closed loop system research going on, that a better form of glucagon than the one currently available will soon be developed and made available.
In my opinion, it doesn’t seem to matter if your T1D or T2D or a surgical T1D. The glucagon whether there or not, is not able to be used in the manner a normal functioning pancreas is able to provide. Therefor, we must supplement the glucagon if the low is incapacitating the PWD or treat the low before it gets that bad with immediate release forms of glucose. I just thought it was interesting to know what is actually happening in the different forms of diabetes, so I’m passing this along to you.
Remember, TEST!! DON’T GUESS!!!